HomeMy WebLinkAboutx2021-2109 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Per
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Description of Work
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OWNER'S NAME
Last TA��! 1\ 1 ���2T ` 1First
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
Last �O_� First , /S
Applicant's Address
l�Jl Applicant's E- I Address
CItY - -. -
State r_._.. Zip r.-.. Telephone_—_. --
ARCHITECT/DESIGNER'S NAME Last r: Lic. N\\rd
First �.,
Architect/Designer's Address
Arc hitect/Designer's E-mail Address
city -. -_..
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ENGINEER'S NAME
Last D C 0%I (.t E �L FirstKP V I N Lic. No. S 4(-707
Engineer's Address
Engineer's E-mail Address
1150 S. OLIVE
STS SurrE f60o KbOCOJn1F-LL (d H.CO.CO/A
Citv LOS AM G E L,5S State C A Zip [_q_0 0 55 Telephone v,1 --271- IR34
CONTRACTOR'S NAME/COMPANY
Lic. No.IR Class
Contractor's Address
Contractor's E-mail Address
City _ _.
State r—.— Zip r—'� - Telephone 0
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. • 24" V
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. , vVLJ
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $