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HomeMy WebLinkAboutX2021-2358 - Permit ApplicationFBuiIdin 'l g (- Grading rDrainage r�Elec Address �� ---��� iv�vr oVtllVlII IHL e t� '"'eCh f— Plum Cu Yd Cut r Cu Yd Filll mailing address) I- Flood r- Fire F-Liq 7 Landslide L -N/A Floor Suite No Description of Work r� Use Const Type A `'a°v+'48i�1 ei- �2ziC#s.�g splart� i?ng d e aill�'a # Stories # Units (if Res) Ct� - New/Add SF � Remodel SF 7 -Is—Garage/New/Add „ �- Valuation $ - -Material/Labor—. SNI >1'L4't / Telephonejfj�t,�2.3 I ca APPLICANT'S NAME Last �— t i �S'i'�_I:.L- LI-P`4a,iYaGJ First ill Applicant's Address -- Applicant's E-mail Address FGP.iD��li✓reaz cit ?�� 9c e� i P ins lei v S I u� t m1 y I�P;a State— Zip �� Tele honeF----- �'_� p �$[1 ?C�i _ca ARCHITECT/DESIGNER'S NAME Last �� a �t vI. d�d$vo�, First _ 5 Lic. No. C i 5 �9 Architect/Designer's Address Architect/Designer's E-mail Address --C.a1c��-x,a� /�itl"._d. �i�� �LJa6L1�ic � - C-1@154 �Saa��tcC,i i City State Zip Telephone 1_11' ZGa 9 - Qi3 ca � ENGINEER'S NAME Last EInvelt-ca l l j FirstiN inc"- 4 Lic: No. � _?l`ei's 4, Engineer's Address i Engineer's E-mail Address a �%1i��1p 1w��15 t I City State f r 1 Zip�i 0 ill iTTelephone 8c'� 94(p-� � t5 CONTRACTOR'S NAME/COMPANY .tt l� s� i Mfr/ Lic. No. y 7 a �yri Class �� Contractor's Address Contractor's E-mail Address i /Uj�(C77//_ �.4 T C>o f / �', f/ city State Zip ���i�. Telephone �i 7 f SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PERMIT NO. PLAN CHECK NO. PLAN CHECK FEES $