HomeMy WebLinkAboutX2019-1667 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permi ppliCltion W
F Comm'I j-", Residential City of Newport Beach - Buildin Divi '
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL s on
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F—Building F_ Grading rDrainage F_ Elec
Project Address (I
lescription of Work
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F Mech j—; Plum Cu Yd cutl Cu Yd Fill
F Flood r- Fire F_ Liq F Landslide F_N/A Floor
Suite No
Use Const Type F_
one # Units (if Res
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dd SF_' Remodel SF� - - - - Valuation $
New/A
Garage/New/Add aterial/Lab 01
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
City State CI 4 Zipt ��'-�
Ce 3 Telephone q -q2 j (, /J 2
APPLICANT'S NAME Last i Aid C'FZ VI
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Applicant's Address
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ARCHITECT/DESIGNER'S NAME
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Applicant's E-mail Address
Zip �' /v !. Telephone(
Last I _. First
Architect/Designer's Address Lic. No.
Architect/Designer's E-mail Address
City State
� Zip �, Telephoned
ENGINEER'S NAME Last F__—�
First F �
Engineer's Address
Engineer's E-mail Address
City F `
State � Zip � Telephone
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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State Zip I `T I 1 i-� Telephone
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SETBACKS REAR SETBACKS FRONT �t
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N0. „
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $