HomeMy WebLinkAboutX2015-1920 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application 0 e
(-i'Comm'1 Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Gv�a�'
F Building (_jGrading �Orainage [IElec -1Mech ,rjPlum CuvdCut� CuvdFill
Project Address (Not mailing address) ❑Flood ❑Fire ❑ Liq ❑ LantlslideN/A Flllloor Suite No
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Description of,Work
Use Const Type F77Ayr—(
#Units (if Res)C
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V luat'� �p
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New/Add SF Remodel SF Gara a/New/Add f I
Material/Llor�
OWNER'S NAME Last First ` J
Owner's Address Owner's E-mail Address
City StateZip F TelephoneE�
APPLICANT'S NAME Last; _, J First`
Applicant's Address ,Applicant's E-mail Address
J
City State L J Zip � Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
:City J State [I Zip Telephone
ENGINEER'S NAME Last J First Lic. No.F__—
Engineer's Address Engineer's E-mail Address
J _ _
City _ , State Zip I Telephoned
CONTRACTOR'S NAME/COMPANY L ,iw rb, u � �ic. No. ^�j2_ Class
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Contractor's Addrps , Contractor's EE -mail Address
Red-
lavl�o�1s 7 Z-,
State Zip .'� Telephone
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VSE REAR - °�SETBACKS FRONT PERMIT NO. l q p
SETBA�GI S LEFT ��' S_' i -BACKS RIGHT PLAN CHECK NO.
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USE ZONE -;,DEVELOPMENT NO PLAN CHECK FEES $