HomeMy WebLinkAboutS2021-0155 - Permit ApplicationsurA- 0155
Print Form o,k eet for Combo Building 8r Solar Permit Application EW�,e
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) f— Flood F- Fire r Liq r- Landslide /A Floor Suite No
Description of Work
Use Const Type
# Storiesr— # Units (if Res)ri
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New/Add SFF_l Remodel SFr -- Gara 9 a/New/Add F_
Valuation$
Material/Labor
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OWNER'S NAME Last r��`1
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last Cil-fJSS First
Applicant's Address Applicant's E-mail Address
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city ,P (zl.,��.� State I '—rte Zip Telephoner
ARCHITECT/DESIGNER'S NAME Last cr agN/�4E2i First C(Z�—', Lic. No. S�!
Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last ��G,�,�� Z First Lic. No. (�h (p s�
Engineer's Address Engineer's E-mail Address
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Lic No. �d�/Class .
CONTRACTOR'S NAME/COMPANY C o „ (1 &O
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Contractor's Address Contractor's E-mail Address
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city State Zip q Telephone
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SETBACKS REAR /� SETBACKS FRONT �r/NPXOr. PERMIT NO.
SETBACKS LEFT (p SETBACKS RIGHT 60 �PP//,,LAN CHECK N0
USE ZONE �j dOa ZriPLAN 4�W
-- DEVELOPMENT N� +' CHECK FEES $