HomeMy WebLinkAboutX2018-0580 - Permit ApplicationWorksheet for Combo Building & S,olar Permit Application °
City of Newport Beach - Building Division
F' comm"Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL -Pow^
F -Building F- Grading F. -Drainage lec F-Mech Plum cu vdcut�i Cu Yd Fill
Project Address (Not mailing address) ,F- Flood 'F- Fire F`; Liq F Landslide F.N/A Floor Suite No
Description of Work
Use F Const Type
# Stories # Units (if Res)(
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kz-
Valuation$
Material/Labor %1,6 OOC
-_
New/Add SF��I Remodel SF Garage/New/Add
OWNER'S NAME LastU First'
6W-ner's"Address 'Owner's E-mail Address
3PU isle r ma rs -1 c� l cwi
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,City ,. �' State I liPl Zip 61 , Telephone
APPL"ICANT'SNAME" Last First
Applicant's Address Applicant's E-mail Address
City �- State Zip TelephondF
--
ARCHITECT/DESIGNER'S`NAME ` Last First Lic. NO.
;.
.ArehitecUDesigner's Address Architect/Designer's E-mail Address
City_ State �— Zip'
rj
Telephone
ENGINEER'S NAME Last First— Lic! No.—
Engineer's Address Engineer's E-mail Address
City �— ` State " �- Zip �— Telephoner
{ONTRACTOR'S NAME/COMPANY dM L Lic. No.l j Class
Contractor's Address Contractor's E-mail Address
City Z (j� ��S state '-A Zip �3 Telephon
SETBACKS REAR SETBACKS FRONT PERMIT NO. - ®'S
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE-' DEVELOPMENT NO PLAN CHECK FEES $