HomeMy WebLinkAboutX2020-2542 - Permit ApplicationWorksheet for Building Combo Permit Application
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Project Address (Not Mailing address)
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Description of Work
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OWNER'S NAME Last�First
Owner's Address Owner's E -mall Address
City - r/ —_I State] Zip
APPLICANT'S NAME Last First)C
AppllcenYs Address ApplicanPs E -mall Address
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ENGINEER'S NAME Last First
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Engineers Address . Engineer's E-mail Address
City I State Zip
Lic. No.
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ENERGY PIC FEE $
FIRE PIC FEE $
GRADING PIC FEE $ _ PLANNING PIC FEE $
ELECIPLLIPA/MECH PIC FEE $
PERMIT NO. /�' UJ'Vj/ • 'V'JI �ilr
PLAID CHECK NO. q W
PLAN CHECK FEE $ _� 3�
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