HomeMy WebLinkAboutX2019-0891 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division 5
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Grading (-Drainage 1—Elec r—Mech F_ Plum cuvdcutr- Cu Yd Fill-�
dress,'(Not mailing address) F— Flood j— Fire (- Liq j Landslide j—N/A Floor Suite No
16 f"�!
F Work, Use Const Type
Stories # Units (if Res)
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Valuation
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Kemodel SFF— Garage/New/Add F — Material/Labor'
E Last First f, j 91NIP�..
§ . Ownees E-mail Address
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State Zip F-- Telephoned
►aIle'; Last First 2 r c /C
ss Applicant's E-mail Address
State � A Zip � ? ` -6 6Telephone '7 �� c� �;� .
SIGWER'S'NAME-
Last First Lic. No. I
ers•Address Architect/Designers E-mail Address
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State Zip Telephone—
CME Lest First Lic.No.
ss Engineers E-mail Address
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.State— Zip— Telephoned
SNAME/COMPANY �/J2 Lic. No, 3999-iz Cla;sI ?y
ress Contractors E-mail Address
State % Zip l % $G� Telephoneitv eec-3,7.
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT PLAN CHECK NO.
DEUELOPWENT NO PLAN CHECK FEES