HomeMy WebLinkAboutX2021-2735 - Permit ApplicationBuilding [Grading j-"Drainage [Elec F_Mech rPlum CuvdCut l CuvdFill
Project Address (Not mailing address) F_ Flood F_ Fire f- Liq r Landslide F_N/A Floor Suite No
Description of Work
Use Const Type
# Stories # Units (if Res)s
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W A U�CK
Valuation$ /j,9�
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New/Add SF�_— Remodel SFI Garag a/New/Add F—
Remodel
OWNER'S NAME Last
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Owners Address
_ Owner's E-mail Address
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City i
State C✓4- Zip Z[c Telephone 32(_ LQ1C
APPLICANT'S NAME Last
E( 1� First L�
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Applicant's Address -
1
Applicant's E-mail Address
City
State Zip C� //�� Telephone
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ARCHITECT/DESIGNER'S NAME
Last First F. Lic. No. I�--
Architect/Designer's Address
Architect/Designer's E-mail Address
City
Zip F_" Telephoner
State 77—
ENGINEER'S NAME Last
First Lic, No.�
Engineer's Address
Engineer's E-mail Address v
City
State Zip F Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No.--- 3i�Gi Glass
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Contractor's Address
Contractors E-mail Address
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-
City e
State � 16- Zip FkjC( p Telephone 1( f - �{ 2-4
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT ; PLAN CHECK N
USE ZONE
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DEVELOPMENT NO !ice"O " 0 i CHECK FEES $