HomeMy WebLinkAboutX2018-0438 - Permit Application (2)Print Form' Wor 7.seet for Combo Building & Solar Permit Application
(—, Comm'I 17 Rsdential City of Newport Beach -Building Division X V0,116
,lam NOTE: PLAN CHECK FEES WEAT TIME OF SUBMITTAL
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Description of Work
Use nst Type
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Valuation $
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OWNERSNAME ast � - First �t
Owners Address Owner's E-mail A/ddress
City State ZipFZTTelephone
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Last l j Ilr` � First_-
App' nt's Address Applicants E- ail Address
City State F_. Zip F7 Telephonel--—
ARCHITECT/DESIGNERS NAME Last First Lic.No.
Architect/Designer's Address
City State F
Architect/Designers E-mail Address
zip F7777 Telephone
ENGINEERSNAME Last First Lic.No -
Engineer's Address
City State
Engineer's E-mail Address
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Zip �— Telephoned—
CONTRACTORSNAME/COMPANYUc.No. c
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Contractor's Address
City State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
Zip /fw�3 TelephoneF9-47
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PERMIT NO.
PLAN CHECK
PLAN CHECK FEES $