HomeMy WebLinkAboutX2019-2563 - Permit ApplicationPrint Form worl(Sheet tor L;0=0 twilaing & Solar Permit Application
Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading (—Drainage F—Elec F_ Mech I— Plum Cu Yd cut Cu Yd Fill F
Address (Not mailing address) I— Flood r Fire r— Liq r Landslide FN/A Floor
of Work
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New/AddSFF —
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Remodel SF !—_ Z Garage/New/Add F—
OWNER'S NAME Last
Owner's Address L �^
C—� F
City State
APPLICANT'S NAME Last
Applicant's Address
City �jQ t �1 . \ r State Ft� f-4-
ARCHITECT/DESIGNER'S NAME Last
Architect/Designees Address t �
City
State
Suite No
Use F—Const Type F_
StoriesF q Units (if
abor
First
Ownwn�er'ss E•-mail Address p,
Co
Zip F Telephoned
First 1 �2x,0
Applicant's E-mail Address
Zip Telephone
First I Lic. No. f
Architect/Designer's E-mail Address r
Zip F Telephone
ENGINEER'S NAME Last First I a 1 � Lic. No.F_
1t
Engineer's Address Engineer's E-mail Address
r�'1 t ,
City V State � Zip Telephone
CONTRACTOR'S NAME/COMPANY
KW-t " U 1
Lic No. �PIlass�
Contractor's Address
Contractor's E-mail Address.`,V�
City
State F—
Zip
Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
1✓/1> 1 .ZS'�.2�j
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NOO..64�4
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $