HomeMy WebLinkAboutF2020-0495 - Permit Application� Print Form Worksheet for Combo Building & Solar Perms �pplicatio n o4a�
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NOTE: PLAN CHECK FEES DUE AT TIME OF SI ffSMIT AI
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Project Address (No ailing address) F Flood Fire yandslide F_N/A Floor Suite No
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Description of Work Y4Xct ire✓ 0�
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Valuation $
Material/Labor Z7049
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Owner's Address Owner's E-mail Address
City State v a' Zip / L,7 Telephoned
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Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last Z
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Architect/Designer's Address Arch itect/Designer's E-mail Address
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Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY �N lE W_ Lic. No. F— Class
Contractor's Address Contractor's E-mail Address
�ity State �— Zip �— Telephone��
TACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT LAN CHECK NO.
USE ZONE -- DEVELOPMEN O - C�- I CLAN CHECK FEES $