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HomeMy WebLinkAboutX2021-2495 - Permit Applicationilding Grading Drainage (-Flet _Mech Plum Cu vd Cut Cu Yd Fill Project Address (Not mailing address) f- Flood r Fire Liq r Landslide 1_N/A Floor Suite No Description of Work Use ��. ` � ConstTypel Uj g # Stories # Units (if Res) ---------- Valuation a New/Add SF �— Remodel SF Garage/New/Add �— Material/Labor'` OWNER'S NAME Last ��- First Owner's Address C Owner's E-mail Address City 1-�.i�C_I A�GAC State — 6 Zip Telephone APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address 11��Gl_ etc- �(L C�-�C�pOQ}jl cS,C City �, StateZip. Telephone -silC� ARCHITECT/DESIGNER'S NAME Last 15, -�1 �{E� First f 04--,1 / Lic. No. �q Architect/Designer's Address Architect/Designees E-mail Address City State �— Zip Telephone F. -- ENGINEER'S NAME Last r n First � c �J,dC�I iic. No. Engineer's Address Engineer's E-mail Address C7 ZS � © �? .. j� r�^t }3�o e t m �� ►E�-t6r+fE'�rr lS,. corn City StateI "ice Zip a Telephone nqq , CONTRACTOR'S NAME/COMPANY Lia No. meq—` Classes-- c Nts, Q �5'y�R11 l Contractor's Address Contractor's E-mail Address City State �— Zip Telephone-Ci� SETBACKS REAR (¢, SETBACKS FRONT j PERMIT NO. ! `��yl �� f SETBACKS LEFT g ev' SETBACKS RIGHT i !� J" t PLAN CHECK NO. C�l'��I - ZZ -7- USE ZONE ®a� DEVELOPMENT NO PLAN CHECK FEES $