HomeMy WebLinkAboutX2021-2559 - Permit Applicationg Grading `-Qrainage F�Elec rMach Plum Cu yd Cut l Cu Yd Filll
BuildinYN
Project Address (Not mailing address) I -Flood f— Fire r Liq F- Landslide FN/A Floor Suite No
Description of Work
Use F_ Const Type
# Stories # Units (if Res)
Valuation
Material/Laa bor "Tf do
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last �l�C First` r /
Owner's Address Owner's E-mail Address
00� )'L, CQ M
CityCF State Zip Telephone
azo
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State F Zip[ Telephoned
ARCHITECT/DESIGNER'S NAME . Last r f First ' 1 i �—
I ' TZ t_e_ A Lic No.
Architectf0esigne s Address Architect/Designer's E-mail Address
/ p
tF ASF �(U�C t p- q��6_av1 R7-zZ '771`y _cd
City State C
State
q J p Y...�ch G�! Zip t Z Telephone
ENGINEER'S NAME Last First Lic. No.1
Engineers Address Engineer's E-mail Address
- -
City State Zip Telephoner
CONTRACTOR'S NAME/COMPANY Lic. No.F9 bq MClass�
1�)iM t�1 0- 61
Contractor's Address�n { Contractor's E-mail Address
J2� "IflX wC��I..: li`.1 •cul ,... - r1A A�- �4,-a
city CI Ci C� �Ae51- State F c Zip F Telephone R't/ 1-6 vi 5 ZC3
SETBACKS REAR SETBACKS FRONT`�__'p PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT,, PLAN CHECK NO.
USE ZONE DEVELOPMENT N 4.% PLAN CHECK FEES $