HomeMy WebLinkAboutPV2023-0069 - Permit ApplicationLfrint Fom, ] W®rkshedt for Combo Building & Solar Permit Application
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Description of Work
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APPLICANT'S NAME Last �(�/NT0 First OS
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ARCHITECT[DESIGNER'SNAME Last First—Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last F First F_ Lic. No.�
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY 1014 ,, Lic. No. �O2i6�/y Class C ��
Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. /'l 2�90
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. /� / 6�t
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $