HomeMy WebLinkAboutXR2024-0540 - Permit Applicationeach -
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I NOTE: PLANCHECKoFES UCJEATTdIMEOFiSUBMITTAL pp
Print Form Worksheet for Combo Building & Solar Permit Application 0� >e
F_ Comm] F- Residential City of
rBuilding rGrading rDrainage rElec F_Mech
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Project Address (Not mailing address) r Flood r Fire r Liq r Landslide FN/A Floor Suite No
2-oC7 C-6 k
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Description of Work
Use F—Const Type F_
# StoriesF_ # Units (if Res)F_
Valuation $
Material/Labor F�1nGr
New/AddSFF— Remodel SFF— Garage/New/Add
OWNER'S NAME Last�
First
Owner's Address
Owner's E-mail Address
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city ,+joor4 6,Z k state cov
Zip[— Telephoned
APPLICANT'S NAME Last �U�niGh
First +c
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Applicant's Address
Applicant's E-mail Address
—
EAc-.
City I State r
Zip— Telephone 9yq-40-/443
ARCHITECT/DESIGNER'S NAME Last �—
First F__ Lic. No. �—
Architect/Designer's Address
Architect/Designees E-mail Address
City I State F—
Zip F_ Telephoned
ENGINEER'S NAME Last %��llnl
First Fi1Z, i II-,_ Lic No. 23c t3
Engineer's Address
Engineer's E-mail Address
2gcs2 CA.,...,nc (::!,-pi_c-ke-4M
City I Legg— ti(,2t��/ State G-}
Zip <r�7�,'�, Telephone ra y,/ yv- $li r
CONTRACTOR'S NAME/COMPANY tall`
Lic. No. 1600-7'6 Classy
Contractor's Address
Contractor's E-mail Address
313rti vtw eoi
City U, ((47t State I 4— —
Zip 9 /362 Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. )(Ru z4, 6sqo
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.L�(/�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $