HomeMy WebLinkAboutX2014-3598 - Permit Applicationb Zol q-0,( )
W rksheet for
3Combo Building & Solar Perm/iitA,piplic
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F;Building [;Grading Drainage F-Elec
Project Address (Not mailing address
of Work
F-! Mech F- Plum Cu Yd Cut l I Cu Yd Fill 1-I
F_ Flood F Fire FI Liq ❑Landslide ( N/A Floor Suite No
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New/Add SF F_
RemodelSFF I Garage/New/Add
OWNER'S NAME Last
Owner's Address
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City _ _ - I State [�
APPLICANT'S NAME Last
Applicant's Address
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City sW LleI State
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Owner's E-mail Address
Zip _ 1�4 Telephone
First
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# StoriesF # Units (if Res)F7
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Applicant's E-mail Address
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Zip L(Z.G�� Telephone ,Y- ( w -zj �
ARCHITECT/DESIGNER'S NAME Last First 177777 Lic. No. F77771
Architect/Designer's Address
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City _ J State [
Architect/Designer's E-mail Address
ZipTele hone
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ENGINEER'S NAME Last First Lic. No.
Engineer's Address
City p �Clµ1 _ _ _J State lz_� J
Engineer's E-mail Address
Zip G�yl�d7_ Telephone��Y���o� ----,
CONTRACTOR'S NAME/COMPANY Lic. No. t0�,3 Class
Contractor's Address
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City G(Ec State
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
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Zip �7�? I Telephone ft-YSS"LIST
PERMIT NO. 'j -3,5 6g gir' 354q
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. L-Int-f r) —
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $