Fillable SMALL PV & SOLAR THERMAL SYSTEM EXPEDITED PERMIT (City of Azusa)

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SMALL PV & SOLAR THERMAL SYSTEM EXPEDITED PERMIT (City of Azusa)

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U.S.A. forms for City of Azusa

BROWSE CITY OF AZUSA (CA) FORMS

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Revised 6/2015
SMALL PV & SOLAR THERMAL SYSTEM
EXPEDITED PERMIT APPLICATION
FOR ONE & TWO FAMILY DWELLINGS ~ ROOF TOP INSTALLATION
PV SYSTEM 10KW OR LESS OR SOLAR WATER HEATING 30 Kw/h OR LESS
CITY OF AZUSA 213 E. Foothill Blvd. Azusa CA. 91702-1395
Contact the Building Department at 626.812.5234 or 626.812.5293
Job Site Address
_______________________________________________________________
PHOTO VOLTAIC SYSTEM 10KW OR LESS
Description of Work ____________________________________________________________
____________________________________________________________
2.
Applicant _____________________________________________________________________________
Telephone (_____) __________________________ Email_______________________________________
3.
Plan Check Contact** __________________________________________________________________
Mailing Address _____________________________ Physical Address ______________________________
City/State/Zip _______________________________ Email ______________________________________
Telephone (_____) __________________________ Fax (_____) _________________________________
1.
Owner ________________________________________________________________________________
Telephone (_____) __________________________ Email_______________________________________
4. Contractor___________________________________________________ OR
Owner/Builder
Telephone (_____) __________________________ Email ______________________________________
Contractor Lic. # ____________________________ City of Azusa Business Lic. # __________________
5.
Engineer/Architect/Plan Designer ______________________________________________
Telephone (_____) __________________________ Email ______________________________________
The applicant warrants that the foregoing is true, and if any of this information is found to be incorrect, the
permit may be revoked.
____________________________
________________________________________________
Owner/Applicant/Contact Signature
Date
** Listing a design professional is strongly recommended. Corrections/plan sets will be returned to the designated contact only.
METHOD OF PAYMENT: CHECK
CASH
CHECK NUMBER
LAST 4 DIGITS
MASTERCARD
VISA
DISCOVER
SOLAR WATER HEATING SYSTEM 30 Kw/h OR LESS
EXP. DATE
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SMALL PV & SOLAR THERMAL SYSTEM EXPEDITED PERMIT (City of Azusa)

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Completed 2 August 2020

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