PROPERTY OWNER(S)
Address
Address
Street Address Line 2
City
State / Province
Zip
Phone: Hm:
Work:
Cell:
GENERAL CONTRACTOR:
License #:
LENDER NAME:
Contact Person:
Phone:
Main:
Main:
Upper:
Lower:
Total:
Remodel:
Base:
Trim:
Accent:
Mfg.
Weight:
Front:
Back:
Sides:
Materials:
Color:
% of Slope:
If Required, Specify Landscaping completion date:
/
Month
/
Day
Year
Date
Completion Date:
/
Month
/
Day
Year
Date
Weight:
Color:
Height:
Size:
Any Proposed Lighting:
Trim:
Accent:
Other:
Mfg.
Materials:
SOLAR PANELS:
5.
Clearly Print Owner's Name
Signature of Owner
Clearly Print General Contractor
Signature of General Contractor
Date
/
Month
/
Day
Year
Date
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