HomeMy WebLinkAboutX2021-3243 - Permit ApplicationForm Worksheet for Combo Building $ Solar Permit Application �EWPoq.
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL J5
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Description of Work d�5%7 l�5/w �v
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OWNER'S NAME Last
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APPLICANT'S NAME Last
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Applicant's Address Applicant's E-mail Address
City I State F_ ZIP F_ Telephone[�
ARCHITECT/DESIGNER'S NAME
Last I `j First F�
Lic No. F�
Architect/Designer'sAddress ArchitectfDesigner's E-mail Address
City F— State F_ Zip [_ Telephone[�
ENGINEER'S NAME Last
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Engineer's Address
Engineer's E-mail Address
city F— State F_ Zip �— Telephone[�
CONTRACTOR'S NAME/COMPANY
Lic No. F— Class_
Contractor's Address Contractor's E-mail Address
City I State F— Zip F— TelephoneF�
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REAR SETBACKS FRONT PERMIT NO. LEFT SETBACKS RIGHT ��{,,c�,PLAN CHECK NO�iVE DEVE>01'_M NT NO,
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