HomeMy WebLinkAboutX2020-2468 - Permit Application1i : Print Form
F Comm'I /Residential
Worksheet for Building Combo Permit Applicationct;r§,
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Project Address (Not mailing address)
Floor Suite No
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Description of Work
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# Stories; # Units (if Res)[ cf,� &b
New/Add SF Valuation$
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OWNER'S NAME Last F
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Owner's/Address
Owner's E-mail Address
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City C6,� I State F -
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last \
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ArchitetctIDesigner's Address
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City
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ArchitectIDesigner's E-mail Address
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ENGINEER'S NAME Last �—
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Engineer's Address
Engineer's E-mail Address
City State �, Zip
F —I Telephone—
CONTRACTOR'S NAME/COMPANY �n/AS�L w1 ',\ � i ._ ,r i � Lic.N L\ ClassF
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Contractor's Address
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Contractor's -mail Address
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City C StateFC Zip
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ENERGY P/C FEE $ FIRE P/C FEE $
PERMIT NO.
GRADING P/C FEE $ PLANNING P/C FEE $
PLAN CHECK NO.
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT #
TOTAL FEES PAID $