HomeMy WebLinkAboutX2018-3602 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit ApplicationcEo'n
Comm'I City of Newport Beach - Building Division n�' ,Vr�
(-' r�Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V
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Project Address (Not mailing address) F_ Flood r i Fire r Liq r Landslide P/A Floor Suite No
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Description of Work
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#Stories #Units (if Res)
Valuation $
Material/Labor
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OWNER'S NAME Last ! First '
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Owner's Address Owner's E-mail Address
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City State - -I
Zip y�Z�j' Telephoned
APPLICANT'S NAME LastFirsth5 -
Applicant's Address Applicant's E-mail Address
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City State�
Zip�?� (k Telephone $a5.I lit
ARCHITECT/DESIGNER'S NAME Last First Lic.No.F
Architect/Designer's Address Architect/Designer's E-mail Ad ress
City State �I Zip j3 W'1 Telepho fj_
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ENGINEER'S NAME Last * — AOI , '��� First '. Lic. No. •030q !
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Engineer's Address Engineer's E-mail Address
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City eAlk - -Pv ,_. State F Zip ef3 lbtj Telephoned;
CONTRACTOR'S NAME/COMPANY Lic. No. ('j71�L9_ Class J3
Contractor's Address Contractors E-mail Address I Z�
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City �j,� (�( yiv,,,p%� State Zip Gf 3 u �Telephone W _yfy -G�fLJ`
SETBACKS REAR �J0 SETBACKS FRONT (P PERMIT NO. X20100 -3(Qfl2.
SETBACKS LEFT (O SETBACKS RIGHT So PLAN CHECK NO. 2-194 f WA 9
USE ZONE DEVELOPMENT NO 9�FJ • �� PLAN CHECK FEES $