HomeMy WebLinkAboutPV2022-099 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
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Description of Work U s *4 ConstType F_
# Stories Units (if Res)
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OWNER'S NAME Last
Owners Address
First
Valuation $
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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city F A FE State tT--,O / N
ARCH ITECT/DESIGNER'S NAME Last First F_ Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
city State
ENGINEER'S NAME
Last F
First
Lic. No. r525114
Engineers Address
SETBACKS RIGHT
Engineers E-mail Address
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City V!,
State
Zip Telephone
Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
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SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
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DEVELOPMENT NO
PLAN CHECK FEES $