HomeMy WebLinkAboutX2018-3044 - Permit Application__-Print Form Worksheet for Combo Building & Solar Permit Application
F Comm"'esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -
F-Building llvc�ding Arainage F_ Elec r-,Mech r-- Plum cuedCut F(7. cued 11i,C 5,
Project ress ( of mailing address) r-, Flood f- Fire F' Liq Kandslide F,N/A Floor Suite No
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n of Work
Use Const Type
# StoriesF- # Units (if Res)F--,...
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Valuation $
Material/Labor Fqf%Ur u-<�
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New/Add SF� Remodel SFF-,�_ Garage/New/Add I /
OWNER'S NAME Last (� j1 First
Owner's Address .-F—\ Owner's E-mail Address
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City ,�. ( State f Zip Telephoned-
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APPLICANTS NAME Last First
Applicant's Address Applicant's E-mail Address
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City / ( State I �' /. f- Zip i� �� Telephor�( t
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ARCHITECT/DESIGNER'S NAME
I% r64,1 v,1 IT First F Lic. No.
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,% Architect/Designer's E-mail Address
Architect/Designer's Address
City Slate r Zip F_—I Telephone.,
ENGINEER'S NAME Last T � d� First F__I Lic. No.F_
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Engineer's Address Engineer's E-mail Address
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City F�, ,y^ ,�/� ,/ State U_ Zip Z� �lPelephoneF
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CONTRACTOR'S NAME/COMPANY Lic. No.7�/ Class
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Contractor's Address Contractor's E-mail Address
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City (N f_ _Vt (1� J State /(• '' Zip ra Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO. '47�C3 k Co
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $