HomeMy WebLinkAboutX2018-3674 - Permit ApplicationP rt ForWorksheet for Cambo Building & Solar Permit Application
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i- Comm'I ( Residential NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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Owner's Address Owner's E-mail Address Y -
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APPLICANT'S NAME Last ��1 First _I"(. " zK
Applicant's Address Applicant's E-mail Address
City �1��,�'" �' State L'�k Zip._q-2.,,"-1 Telephone ;'2,�j..y�" 2i�)7TJ
ARCHITECT/DESIGNER'S NAME Last (f t% u First k Lic. No. G
Architect/Designer's Address - Architect/Designer's E-mail Address
City (J I'-%t/�C�r `jaCj ( State ` Zipy. L� Telephone '
ENGINEER'S NAME Last r-- First— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City ,. State F Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY Lic No. F Class
Contractor's Address Contractor's E-mail Address
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City State F Zip r_ Telephoner
SETBACKS FRONT PERMIT NO. Lel 9)
SETBACKS REAR
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Z"vSz-('20l
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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