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HomeMy WebLinkAboutX2015-2884 - Permit ApplicationPrint Form worksbeat for Combo Buliding & SOW Permit A I cationCity of each - Building rEW�rm sion F- Comm'I F_ Residential NOTE: PLAN HE Kort FEES DUE AT TIME OF (SUBMITTAL s rBuilding F- Grading rDrainage r'Elec j Mech F-Plum CuYdCut cuYdFill Flood r• Fire Li Prrogect Address (Not mmaillhing address) !_ r q r Landslide rN/A Floor Suite No Description of Work Use Const T e yp o 9-AriL_ -F tL_?A-tiIL ALA LF_ # StoriesF—. #Units (if Res)I_01 I' Valuation $ r New/Add SF1 Remodel SFF Garage/New/Add F Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Address City _ State I-: Zip r Telephone( APPLICANT'S NAME Last �— First Applicant's Address Applicant's E-mail Address City State F_ Zip Telephone ARCHITECT/DESIGNER'S NAME Last First Lic. No. �. Architect/Designer's Address Architect/Designer's E-mail Address City � State �—. Zip Fu TelephoneF_. ENGINEER'S NAME Last First Lic No.r— Engineer's Address Engineer's E-mail Address City State : Zip —: Telephoner CONTRACTOR'S NAME/COMPANY Lic No. %LipLiZClass I IS Contractor's Address Contractor's E-mail Address 34L(©1 U1o, _s(A ./ Sum LKf6tW— W� TcN1�f 1. , CON(. City 15TICAljj) r1) _: State �,. Zip-12.6Z1.... Telephone q4l 390- W 3 ... . SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $