HomeMy WebLinkAboutX2018-2040 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o 9�
Comm'I (— Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F,Building F Grading FlDrainage F Elec F Mech F Plum CUYdCut [_ Cu Yd Fill F_i
Project Address (Not mailing address) F Flood F Fire F Liq Fi Landslide FIN/A Floor Suite No
Description of Work / T�ConstType
,. # StoriesK, li It Units (if Res)n
Valuation
New/Add SF�; Remodel SFF— Garage/New/Add �—'� Material/Labor
OWNER'SNAME Lastl/A j/�/(%_CU,Firstl.-.- _-----..___--.----
Owner's Address Owner's E-mail Address
City State �— Zip �I; Telephoned —
APPLICANT'S NAME Last I �y(f�y-jC -_ _ _ First I )
Applicant's Address Applicant's E-mail Address
2r�/ /z A A o� ✓4 ✓� cJz f c rrrP L
City FEA� 11A / � State �.,., Zip � Z662- Telephone
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ARCHITECT/DESIGNER'S NAME Last,Z(/ 1 First-�i,�,�i_
Lic.
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ArchitectlDesigner's Address Architect/Designers E-mail Address
City State �� Zip ��I Telephoned��i
ENGINEER'S NAME
Engineer's Address
City
Last First �— Lic, No.
Engineer's E-mail Address -
CONTRACTOR'S NAME/COMPANY
Contractors Address
City
State - Zip �— Telephone�i
Lic.No.Wl-qj Class��
Contractor's E-mail Address
State r Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. _ 6
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $