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Worksheet for Combo Building & Solar Permit Application
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OWNER'S NAME Last IVA
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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ARCHITECT/DESIGNER'S NAME Last FlTev, ztihZA First vl^_�1 I r Lic. No. �l
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ENGINEER'S NAMELast
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Engineer's E-mail Address
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Telephone
Zip Telephone
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CONTRACTOR'S NAME/COMPANY (_ �
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Contractor's E-mail Address
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SETBACKS REAR G SETBACKS FRONT ZO PERMIT NO(5ZD � —QM3/9&1 /
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PLAN CHECK FEES _
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