HomeMy WebLinkAboutX2018-2007 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
comm"Residential City of Newport Beach - Building Divisiol, - 5 a
NOTE: PLAN CHECK FEES DUE AT TIME OF SU MI AL
F'Building ❑Grading nDrainage ❑Elec ❑Mech
❑Plum Cu Yd Cut17 Cu Yd Fill F71
Project Address (Not mailing address) ❑ Flood
❑ Fire ❑ Liq ❑ Landslide MN/A Floor Suite No
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Description of Work
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#Stories❑ #Units (if Res)
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Valuation $
Material/Labor
New/Add SF� Remodel SF[ Garage/New/Add ��
OWNER'S NAME Last`l`rl-
First I EL Zc_ g?
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
JI_--
First `�(r za Vl
Applicant's Address
Applicant's E-mail Address
City State
Zip Telephone�li
ARCHITECT/DESIGNER'S NAME Last First F— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephoned
ENGINEER'S NAME Last
First Lic. No. _ ;,_.,-A•
Engineer's Address
Engineer's E-mail Address
City State F777
Zip F7777 Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. Class[
Contractor's Address
Contractor's E-mail Address
City _ State ��
Zip Telephone
7TBACKS REAR SETBACKS FRONT
PERMIT NO. l-0I 2�• Z 0
'BACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
ZONE DEVELOPMENT NO
PLAN CHECK FEES $
Worksheet for Combo Building & Solar Permit Application
Comm'I r esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
f Ci1ding r Grading
F-Drainage F- Elec MMe�ech
F_ PlumYdcut cuvdFill F
Project Address (Not mailing addressp`"rlood
F- Fire Liza Fr Landslide F_N/A Floor Suite No
Description of W rk
Use onstType
# Stories # Units (if Res)w
U C I
sort?
� ct
Valuation S
New/Add SFF
Remodel SF !6— Garage/New/Add F_
Material/Labor i ��
OWNER'S NAME
Last t AW
First)
1, 3
Owner's Address
Owner's E-mail Address
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City I �e 9� ��
State
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Zip Telep one '709- 6
APPLICANT'S NAME
Last w� W S0�
First
Applicant's Address
Applicant's E-mail Address
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city �(�
State
Zip Gta133 Telephone $�>- aas-1aae/
ARCHITECTI/DESIGNER'S NAME Last First Lic. No. F-
Architect/Designees Address
r6Fitect/Designer's E-mail Address
City
State F--
Zip I Telephone
ENGINEER'S NAME
Last i
First F Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State I
Zip F Telephoner
CONTRACTOR'S NAME/COMPANY tosv`-1 00(vAire
U foA Lic. No. Q-17/7- ff 0assFT
Contractor's Address
Contractor's E-mail Address
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City U[�P l�
State
I C �I
/ a Zip Telephone g/ ? as f 1p�
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO. J ` !19 1
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $