HomeMy WebLinkAboutXR2022-2225 - Permit ApplicationPrint Form-J Worksheet for Combo Building & Solar Permit Application (690
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Project Address (Not mailing address) 1- Flood r" Fire r— Liq r Landslide F_N/A Floor Suite No
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Description of Work
Use ConstType�
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# Stories # Units (if Res)F—
Valuation $— Material/Labor
New/AddSF� Remodel SF Garage/New/Add
OWNER'SNAME Last Fq First
Owners Address Owner's E-mail Address
City State �— Zip F_ Telephone
APPLICANT'S NAME Last � � First �C
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �—
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City State �— Zip �— Telephone
ENGINEER'S NAME Last First F Lic. No.�—
Engineer's Address Engineer's E-mail Address
City State F® Zip F Telephoner
CONTRACTOR'S NAME/COMPANY J� //�� 64JC7S rLic. No. Class
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Contractor's Address Contractor's E-mail Address
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City / �-
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SETBACKS REAR SETBACKS FRONT PERMITNO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. !W V
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $