HomeMy WebLinkAboutX2021-2393 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permi P li ation
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Project Address (Not mailing address) F Flood
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OWNER'S NAME Last I F'EL)WIN W>
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last t-ENM•1%��
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last
FirstF Lic No. F—
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City I State F— Zip F TelephoneF_
ENGINEER'S NAME Last
First 7— Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State �— ZIPF Telephoned
CONTRACTOR'S NAME/COMPANY q jt l I k(� IZ C0K.5_MU( ,V-1 ,p k Lic. No. `J3 1 Z Class
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Contractor's Address
Contractor's -mail Address
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City I V.CI[J I-VAC5� State I CA— Zip
q'� Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. � V bib b
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. O
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $