HomeMy WebLinkAboutX2019-1528 - Permit Applicationrur v®mpo building & Solar Permit Application
Comm I F Residential City of Newport Beach -Building Division xI 0 -V j a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Buildin
g Grading F`Drainage F- Elec r Mech Plum
cavdcucl Cu Yd Fill
Project Address (Not mailing address) Flood j Fire
F Liq Landslide F -N/A Floor Suite No
ascription of Work
_ Use Const Type
# StoriesF— # Units (if Res)
New/Add SF� Remodel SF a alum
Garage/New/Add Material/Labor
OWNER'S NAME
Last ..First
Owner's Address
Owner's E-mail Address
City State F'
- Zip F'
Telephone��
FC
AME Last
First
Applicant's Address - -
Applicant's E-mail Address
State r�(�
Zip IepponB
SIGNER'S NAME 1 LL
Last 2 ,Ciirst
ees Address I V s Lic. No. �
Architect/Designer's. E-mail Address
_.:_._._
State Zip F� Telephoned
ENGINEER'S NAME Last4
First Lic. No.�
-
Engineer'sAddress
Engineer's E-mail Address
City
State �� Zip Telephone
CONTRACTOR'S NAME/COMPANY 1 �����[JJJjjj Class
1v l 6lSU� Lic No. I OI r
Contractor's Address
Contractor's E-mail Address
611
City 5( t^^=� . �„�
State �}.
Zip Telephone 310 a-.�D38"
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO,
SETBACKS RIGHT
PLAN CHECK N0.
USE ZONE .DEVELOPMENT NO �'—
PLAN CHECK FEES $