HomeMy WebLinkAboutX2019-0792 - Permit ApplicationPrint Form ��worKsneet for compo tsuilaing 6t Solar vermlt
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Comm'Ir e✓R sidehtial City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF "
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Description of Work
OWNER'S NAME Last LIS�j7i r
Owner's Address f�
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City I al� I Oe4 I State F2-_W_
APPLICANT'S NAME Last F�
First I �Gp
Owner's E-mail Address
Zip I�%Te
Applicant's Address
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City I\ 1 -P? State r Zip
ARCHITECT/DESIGNER'S NAME
E-mail Address
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Last I �V First I j Jr A n/1 Lic. No. F—
Architect/Designer's Address Architect/Designees E-mail Address
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City State Zip Telephon t b
ENGINEER'S NAME Last
Engineer's Address
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City �� State�-
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City I
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
First Fq
Engineer's E-mail Address
Lic. No. J 71 39
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Zip F12� �7 Telephone 'j iM)
Lic. No. F Class
Contractor's E-mail Address
Zip I— Telephone[—
PERMIT NO. �VtJ 4�
PLAN CHECK NO. U ( Z
PLAN CHECK FEES $
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USEZONE DEVELOPMENT NO PLAN;CHECK FEES $
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