HomeMy WebLinkAboutX2019-2438 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
(` Comm'] j 'Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r flood
F_ Fire F_ Liq F Landslide F_N/A Floor Suite No
Description of Work
Use I Const Type I—.;
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# Stories #Units (if Res)'
New/Add SFF —� Remodel SFF—� Garage/New/Add F !
Valuation $.
Material/Labor FP
OWNER'S NAME Last f _.T— h e— `L(J First
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME�)/
Last K✓l�4SSr�
First C/ -
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First .Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City -- State
Zip I Telephone
ENGINEER'S NAME.
First s� Lic. No.K., 4V;9_1,t,Z_
Engineer's Address
Engineer's E-mail Address
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State G /�ZipJFBF
Y.1City
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CONTRACTOR'S NAME/COMPANY / Lic No.;.�1/��� Class --
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. '4_7 1 _
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO -
PLAN CHECK FEES $