HomeMy WebLinkAboutX2018-3541 - Permit ApplicationPrint Form A Worksheet for Combo Building & Solar Permit Application
F- Comm'I (— Residential City of Newport Beach - Building Division
l NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F_ Grading rDrainage rElec rMech F_ Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) 1- Flood r Fire r Liq r Landslide [N/A Floor Suite No
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Description of Work
Use Const Type F
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Valuation
New/Add SF Remodel SF Gara a/New/Add
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Material/Labor
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
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APPLICAvN\Tt''St. N/AKM/E�t Last ICL I� First
Applicant's Address (44 Applicant's E-mail Address
City State �T ZipivS Tele one
ARCHITECT/DESIGNER'S NAME Last First IF_
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City � State F_ Zip F Telephone
ENGINEER'S NAME Last First F_ Lic. No.F_
Engineer's Address Engineer's E-mail Address
City State r_ Zip F- Telephone
CONTRACTOR'S NAME/COMPANYZ Lic. No. ? Class
Contractor's Address �/ Contractor's E-mail Addres
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SETBACKS REAR SETBACKS FRONT PERMIT NO. X( 01L%41
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 213�i�2oi $
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $