HomeMy WebLinkAboutX2019-2654 - Permit ApplicationPrint Forn4 Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI
F-Building I— Grading
[—Drainage F lec �Aech Cu Yd Cut Cu Yd Fill
7"M F
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq Landslide F_N/A Floor Suite No
Description of Wibrk
Use Const Type
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/t.
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# Stories # Units (if Res)
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Valuation $ `.
Material/Labor Zs
d�
New/Add SF
Remodel SF . Garage/New/Add I r
OWNER'S NAME
Last ,�First
Owner's Address
Owner's E-mail Address
t 2ro 9/?L(VE � c e n C- /�v
City (t/�O®� j r/j,�r State 4 Zip �ZE;C Telephone
APPLICANT'S NAME
Last F— First
Applicant's Address
I—
Applicant's E-mail Address
F
City
State Zip [_ Telephoned
ARCHITECT/DESIGNER'S NAME
Last F— First F Lic. No. �
Arch itect/Designer's Address
F�
Architect/Designer's E-mail Address
F
City
State � Zip � Telephone F_
ENGINEER'S NAME
Last ��' First Li . No.F^
C__ 4r2�51�61
Engineer's Address
Engineer's E-mail Address
F____
City
State F_ Zip F Telephone F_
CONTRACTOR'S NAME/COMPANY
Lic. No. Cj J' /y �:� Class F
(t� l� C,
Contractor's Address Q ��- L� �� C' 5�� r� e ��` Contractor's E-mail Address
1 1
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1
City /1 � � � � l �
State c� n Zip C� L�� 0 � Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 0Y
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
U,SE ZONE
DEVELOPMENT NO PLAN CHECK FEES $