HomeMy WebLinkAboutX2018-1983 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F comm" Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F Grading F-',Drainage [-KErc F-iMech F_ Plum CuYdCut F CuYdFill F_.
Project Address (Not mailing address) F7 Flood [I Fire n Liq I — Landslide rN/A Floor Suite No
f+V*j F �—
Description of Work
Use 7—' ConstType
ZJ22 2S. VE: i ' 4&� L� i r>L /.�
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# Stories'. # Units (if Res)F—
Valuation $
Material/LaborFd 75o
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New/Add SF Remodel SF _ '. Garage/New/Add I '
OWNER'S NAME Last {,�(Lr . !�'rT> First
Owner's Address Owner's E-mail Address
City State— Zip Telephoned
APPLICANT'S NAME Last Vni rz,First'.
Applicant's Address Applicant's E-mail Address
City I ` t; t2.. 1 State � Zip � 4 r Telephone (j,�Di�, .Z e�g
r t
ARCHITECT/DESIGNER'S NAME Last �_ �J First F Lic. No.
Architect/Designer's Address���(��-"� Architect/Designer's E-mail Address
City State � Zip F_ Telephoned
ENGINEER'S NAME Last First ��-y Lic. No.�'.
—Address
Engineer's Address Engineer's E-mail
City State %—� Zip C'Z� t Telephone'
yNAM�E/PCyO/M?PrANY
CONTRACTOR'S ^� Lic. No. Class
�
Contractor's Address Contractor's E-mail Address
City State Zip [' Telephone-'
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ S