HomeMy WebLinkAboutX2019-0426 - Permit ApplicationPrint Form WO sheet for Combo Building & Solar Permit Application ��`�m
Comm'I r_1 Re e o T-()LtCity of Newport Beach - Building Division 01
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 1011
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Project Address (Not mailing address) I- Flood r Fire ri Liq r, Landslide rN/A Floor Suite No
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Descriptionof Work
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OWNER'S NAME Lash -- First M I f-6
Owner's Address I Owner's E-mail Address
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APPLICANT'S NAME Last � Ghrls � f) First FF17iq r
Applicant's Address Applicant's E-mail Address
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City I �-In'tgYl�l State, Zip 2� Telephone �I-_
ARCHITECT/DESIGNER S NAME Last , /@ Lic. No.
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ArchitecttDesigner's Address Architect/Desi ner's� ill Addressy
City State Zip Telephoned
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ENGINEER'S NAME Last First ' Lic. No.F—
Engineer's Address Engineer's E-mail Address
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City State Zip �!, Telephone
CONTRACTOR'S NAME/COMPANYLic. No. l Y Class (
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Contractor's Address Contractor's E-mail Address
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City Cin}�/�An q State �A Zip 2r Telephone �1 I
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SETBACKS REIA_R' SETBACKS FRONT PERMIT NO. %�_ZO `1.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C):/� l ��
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $�.��
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