HomeMy WebLinkAboutX2021-2482 - Permit ApplicationProject Address (Not mailingaddress)I-
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Description of Work
Use F— Const Type
#Stories #Units (if Res)-
New/Add SF�— RemodelSF— � Valuation$
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-Owner's E-mail Address
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APPLICANT'S NAME q'_
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last First eitifY�) �� Lic.No.—
ArchitecUDesigner's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME YYY"' Last F777777777"'��� '
First Lic. No,
Engineer's Address Engineer's E-mail Address
City State Zip Telephoner
CONTRACTOR'S NAME/COMPANY
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City
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SETBACKS REAR { SETBACKS FRONT PERMIT NO. YI Lb's,( , �Llf
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. L
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USE ZONE.
DEVELOPMENT NO PLAN CHECK FEES $