HomeMy WebLinkAboutX2019-3917 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4�EW�,
F_ Comm'I (J Residential City of Newport Beach - Building Division "`opY
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building r Grading
r`Drainage r Elec r Mech f— Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood 7 Fire F_ Liq r- Landslide f N/A Floor Suite No
Description of Work
Use ConstType
# Stories # Units (if Res)
Valuation $
Material/Labor
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New/Add SF��
Remodel SF F— Garage/New/Add F --...
OWNER'S NAME
Last N�h�y L� First
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Owner's Address
Owner's E-mail Address
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City �. State x Zip Telephone
APPLICANT'S NAME
Last (J��.� First
Applicants Address
Applicant's E-mail Address
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City ``�,�,uvw State Zip/7;,F�ii
ARCHITECT/DESIGNER'S NAME
Last First I� Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F_ Zip TelephoneF_
ENGINEER'S NAME
Last � First .�-� Lic No.
Engineers Address
Engineer's E-mail Address
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city�
State Zip Telephone
Telephone
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CONTRACTOR'S NAME/COMPANY �� �f Lic No. Class
Contractor's Address
Contractor's E-mail Address
City State — Zip Telephone �cl"�r-y 1 �,S- 2G(�
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $