HomeMy WebLinkAboutX2021-1091 - Permit Application"' Worksheet for Combo Building & Solar Permit Application
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Y.
Description of Work
Y
User, Const Type
# to e # Units (ifR s)y
_
New/Add SFF
Remodel SF F ---
Garage/New/Add
Nia erial/La or
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State Zip F__ Telephoned--
APPLICANT'S NAME
Last --
First
Applicant's Address -
Applicant's E-mail Address
City
State �.--
Zip F_ Telephone—
ARCHITECT/DESIGNER'S NAME Last �----
First F_- Lic No. r—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_
.Zip I------�-- Telephoned -..------
ENGINEER'S NAME
Last
First ,7—_-----. Lic. No.F_
Engineer's Address
EngineersE-mail Address
City (`—
State
Zip r Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. F Classy
Contractor's Address
Contractor's E-mail Address
City _
State F_
Zip r Telephoners-,
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO i
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
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