HomeMy WebLinkAboutX2019-3132 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4z6�P0,@
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City of Newport Beach - Building Division omm'I ( Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c,.oar,P
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Description of Work
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OWNER'S NAME Last r (�CX`UC 1�
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last VVI ec�� ,x_!c
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Applicants Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last i2 i e }} First �—'
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Architect/Designer's Address
ArchitecVDesignees E-mail Address
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Zip �� ,- y 1 Telephone
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ENGINEER'S NAME Last �� r
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Engineer's Address
Engineer's E-mail Address)
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Zip �.-j Telephoned.
CONTRACTOR'S NAME/COMPANY 4 tic / � Lic. No. 1 �sZ7yClass
Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. �'�•• '�T�,
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Oil . 1
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $