HomeMy WebLinkAboutX2021-3373 - Permit ApplicationI� _ _-__'{ W rks et for Combo Building & Solar Permit Application
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NOTE: PiLAN CHECK ty of OF ES UEATTIME OFeach - Building iSUBMITTAL
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Description of Work
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Stories % #Units (if Res)
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Valuation
New/Add SF� Remodel SFF Garage/New/Add
$
Material/Labor
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
City .t� �1
State Zip 23 Telephone
APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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City ✓6G�
State Zip 92gp4P Telephone /7J14_e32-8a7-Z_
AR`r/DESIGNER'S NAME
Last ,/A i1 I 4 First �4� i F
/� v� Lic. No.
Architect/Designer's Address
ArchitecUDesigners E-ma ddress
City
State Zip F_ Telephoned
ENGINEER'S NAME Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip Telephone F_
CONTRACTOR'S NAME/COMPANY
Lic. No. raj qo oClass lo%
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Contractor's Address
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Contractor's E-mail Address-
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. U
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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