HomeMy WebLinkAboutX2019-2212 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
❑ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL f�
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Project Address (Not mailing address) ❑ Flood ❑ Fire 1
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of Work
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New/Add SF ig�,f�1� Remodel SF ?j p-7/ Garage/New/Add
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Cu Yd Fill 1 --1
❑N/A Floor Suite No
T.iC-71
Const Type V$
Stories # Units (if
3az7
OWNER'S NAME Last �(C> First J
Owner's Address Owner's E-mail Address
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Last
Applicant's Address
City State
First
Applicant's E-mail Address
Zip Telephone
ARCHITECT/DESIGNER'S NAME
Last 1 5,0, "1 First Lic. No. C'32a
Architect/Designer's Address
City (� T-^-- KAV5: -- State
Architect/Designer's E-mail Address
Zip 9�(Z Telephone !f ts'rj-'Z-7Z"`�
ENGINEER'S NAME Last _✓ t (�1 _( I First /kttti ((z Lic. No. 5qa R
Engineer's Address Engineer's E-mail Address
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City lam' � f �[� State ® Zip C� Telephone �79
CONTRACTOR'S NAME/COMPANY � � Lic. No. Class F7
Contractor's Address
City State
Contractor's E-mail Address
Zip Telephoned
SETBACKS REAR / U' SETBACKS FRONT I Da
SETBACKS LEFT3( SETBACKS RIGHT j r
USE ZONE DEVELOPMENT NO
PERMIT NO. YdD —2,-2-12—
PLAN
'ZZ12—
PLAN CHECK NO. /
PLAN CHECK FEES $