HomeMy WebLinkAboutXC2023-0234 - Permit ApplicationWOrksheet for Combo Building & Solar Permit A 1'
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OWNER'S NAME '---�
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APPLICANT'S NAME
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ARCHITECT/DESIGNER'S NAME r
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ENGINEER'S NAME
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Architect/Designer's E-mail Address
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Last _ I First
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city _ State
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Lic No.�
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Zip--- Telephone
CONTRACTOR'S NAME/COMPANY
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Contractor's Address t-- i Classy i
Contractors E-mail Address
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Ciry State
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SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. l «cy23- 02 ?q
PLAN CHECK NO. R Z 3 - I
PLAN CHECK FEES $