HomeMy WebLinkAboutXR2024-1092 - Permit ApplicationPrint Form
- Worksheet for Combo Building & Solar Permit Application
(- Comm'I (S; Residential City of New rt B
Building
po each - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL_
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i•roject Address (Not mall
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le$cription of Work
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r Mech r plum
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F Flood F Fire r Liq j- Landslide
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New/AddSFF_�
Remodel SFF_� Garage/New/Add �-
OWNER'S NAME
Last 1 . � �
Cu Yd Fill
rN/A Floor Suite No
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Use 1� ConstType�-
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Valuation $
Material/Labor
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APPLICANT'S NAME
Last
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City
ARCHITECT/G
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NAME
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Architect/Designer's Address
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State FAJ
Iwvirvccn b NAME
Last
Engineer's Address
City
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CONTRACTOR'S NAME/COMPANY
First I 'Wl ('
Applicant's E-mail Address
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Zip Telephone `��.7I )I _, ,i1
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First �'
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Zip ` , Telephone a¢ 7 - � 9' f� _
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Engineer's E-mail Address
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Contractor's Address r Lic. No. s7�7// Class
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Zip iZ Telephone �y
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_TBACKS REAR
:TBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO, is
W
;E ZONE
DEVELOPMENT NO
PLAN CHECK NO.
PLAN CHECK FEES $