HomeMy WebLinkAboutX2019-1312 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ocEW�Ra
F_ Comm'I F_ Residential City of Newport Beach -Building Division 4
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building Grading
rDrainage F_ Elec r Mech r Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) f- Flood ( Fire r Liq (` Landslide f N/A Floor Suite No
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Description of Work,
Use F—Const Type I
L
# Stories[— # Units (if Res)[—
3�1 r +c i2t
Valuation$Ff
New/Add SF
`��
Remodel SF Garage/New/Add
Material/Labor 12v! DOv
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City �
State F_ Zip [_ Telephoned
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City �
State F_ Zip F_ Telephoned-
ARCHITECT/DESIGNER'S NAME
Last First r Lic. No. �9
00
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
;ity
State �— Zip Telephone
ENGINEER'S NAME
Last First— Lic No. �l �/ 6
Engineer's Address
Engineer's E-mail Address
CiTy
State F_ Zip I Telephone
CONTRACTOR'S NAME/COMPANY / 1l Lic No.��( Class
J L/L /
Contractor's Address
Contractor's E-mail Address
1�
City C,fT6t ����{
State L/7 Zip `"Z(p Telephone 71f�-5���
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SETBACKS REAR
SETBACKS FRONT PERMIT N0k
SETBACKS LEFT
_
SETBACKS RIGHT PLAN CHECK NO. ')
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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