HomeMy WebLinkAboutX2015-1970 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r'-1 cnmm'I F Residential
City of Newport Beach - Building Division
i aN CHECK FEES DUE AT TIFAF nF: SUBMITTAI
Building F7 Grading I -!Drainage F-Elec F-Mech F_ Plum cuvdCut r— cuvdFill
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Project Address (Not mailing address) - Flood [ i Fire [i Liq Landslide CN/A Floor Suite No
Description of Work Use Const Type r-7
# Stories[7 # Units (if Res)r_1
----- - Valuation
Remodel Garage/New/Add Material/Labor
New/Add SFF --
OWNER'S NAME Last First _ J
Owner's Address Owner's E-mail Address
City - _ _ _ State Zip F J Telephone
-
APPLICANT'S NAME fast First _
Applicant's Address Applicant's E-mail Address
City _� State C Zip C� Telephoned—
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last J FirstF—I Lic.No.�
Engineer's Address Engineer's E-mail Address
City J State Zip --®'I Telephoner—
— RACTOR'S NAME/COMPANY — - /nQ ��� Ic• N` g f—ge— � Class26
Contractor's Address Contractor's E-mail Address
City State Zi Telephone (���
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $