HomeMy WebLinkAboutE2022-0775 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o�
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Description of Work
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# Stories # Units (if Res)
New/Add SF� Remodel SF Valuation $
Garage/New/Add F— Material/Labor
OWNER'S NAME Last
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Owner's Address _.
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Owners E-mail Address
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City
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ZipTelephone 7�a
APPLICANT'S NAME Last �—
First
Applicant's Address - --
Applicant's E-mail Address
_...... _
City F _
State Zip Tele hone—
.___ _. __.
ARCHITECT/DESIGNER'S NAME Last —
First
_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
_ ____.. __ Zip Telephone
ENGINEER'S NAME Last
_ First Lic. No.
Engineer's Address Engineer's E-mail Address
City
State
Zip Telephoner _ "f41
CONTRACTOR'S NAME/COMPANY
Lic. No. to V N r Class
Contractor's Address Contractor's E-mail Address
.......... _
City State
_ Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
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