HomeMy WebLinkAboutXR2024-0051 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r-Building F_ Grading
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Project Address (Not mailing address) F_ Flood
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Description of Work
Uses ConstType s
# Stories # Units (if Res)F—
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New/Add SFF
Remodel SFF Garage/New/Add
F—
Valuation $
Material/Labor 9zs . cSc
OWNER'S NAME
Last C v Lt First
Owner's Address
Owners E-mail Address
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Zip 2663 Telephone —
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APPLICANT'S NAME
Last �� ��
First
Applicant's Address
Applicant's E-mail Address
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City State
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ARCHITECT/DESIGNER'S NAME Last
First F Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F—
Zip F Telephone�—
ENGINEER'S NAME
Last
First 7— Lic. No.s
Engineer's Address
Engineer's E-mail Address
City
State
Zip F Telephone
CONTRACTOR'S NAMElCOMPANY Lic. No. 0 6 Class
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO. XjW o`q •'SOS I
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. ft0��- 6033
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $