HomeMy WebLinkAboutX2018-2020 - Permit Application (2)Print Foam_ W net for Combo Building &Solar It lication oPo"e
F]Comm'I gp Residential I City of Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ;�..•�
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Project Address (Not mailing address) [7 Flood ❑ Fire ❑ Liq F]Landslide /A Floor Suite No
Description of Work Use Const Type
t f7 t1� # Stories # Units (if Res)
Remodel SF Garage/New/Add
OWNER'S NAME Last First �
Owner's Address Owner's E-mail Address �� o
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City - State Zip Telephone
APPLICANT'S NAME Last c !10 . ,ra x N First ,. \
Applicant's Address t u
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City D D State
NAME
Applicant's E-mail Address
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Zip - Telephone
E-mail Address
City 11 )11,V1A IA'10 _l— I State jj )�" I Zip
Lic. No.
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ENGINEER'S NAME Last First Lic. N . ,^ ii
Engineer's Address
City State
Engineer's E-mail Address ', a ' t 9
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Zip Telephone I
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CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address
City State
Contractor's E-mail Address
Zip L� Telephoned
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT,,((����,,
USE ZONE DEVELOPMENT N&>,) I�b, o It -s
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $