HomeMy WebLinkAboutX2018-0055 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G4�w�s
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Project Address (Notmailing; address) 1- Flood F.- Firer[- Liq (- Landslide, FN/A, Floor Suite No
Descriptions of WorkX 2i r711
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OWNER'S NAME LastVw First
Owner's Address - Owners E-mail Address
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APPLWANTS'NAME, Last f �qf First
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last ` I d C1 First �-z_ Lic. No. F___`
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ENGINEER'S NAME ° Last First70 Lic.No,
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Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY �/�A \�(i Lic.No. IU� Class C`Z7
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SETBACKS REAR C SETBACKS FRONT PERMIT NO. X4419. dO
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 16
USE ZONE- '/Z -� li�'%OQ DEVELOPMENT NO PLAN CHECK FEES $'