HomeMy WebLinkAboutX2017-3715 - Permit Application (2)X Wfork,sheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Comm'I j Resident 1 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address
of Work
New/Add SF Remodel SF
OWNER'S NAME Last
Owners Address
City
APPLICANT'S NAME Last
Applicant's Address
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Suite
Garage/New/Add
Owner's E-mail Address
Use ConstType
# Units (if Res)F—
Valuation $ Material/ bor 3 vU
State I Zip I — Telephone —
First I
Applicant's E-mail Address
City
State �— Zip' Telephone_
ARCHITECT/DESIGNER'S NAME Last
Architect/Desigi tees Address
City - State
ENGINEER'S NAME Last
First Lic. No.
ArchitecNDesigner's E-mail Address _
Zip Telephonel.
First
Lic. No.1
Engineer's Address Engineer's E-mail Address
City
State Zip i Telephoned
I Lic. No. Ind Z53`j_ Class
CONTRACTOR'S NAME/COMPANY .. �(I r /p
Contractor's Address l �p Contractors E-mail Address
( State
City I%A- Zip j 9Z fjb Telephone!-71q Z53 Z`15
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SETBACKS FRONT PERMIT NO. 201 w ✓✓"✓ 1
SETBACKS REAR
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Ill-I�ViI `(�L
PLAN CHECK FEES $
USE ZONE DEVELOPMENT NO
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