HomeMy WebLinkAboutS2019-0170 - Permit Application9 Application
FrintForm Wor deet for Combo Building & Solar Permit r
\ City of Newport Beach -Building Division SUBMITTAL '�� j (�
( Comm'I (Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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OWNER'S NAME Last /1/jJR-AlSn/J
Owner's E-mail Address
Owner's Address
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APPLICANTS NAME Last C L) 2_
Applicant's Address
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City F L 4lw FL State I ARCHITECT/DESIGNER'S NAME Last F_
City
ENGINEER'S NAME
Engineer's Address
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Suite No
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25 -.757.6g2 -
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State I ` — Zip
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CONTRACTOR'S NAMElCOMPANY
Contractor's Address
21� S �. CHAP(�AN
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First
Architect/Designer's E-mail Address
First) 'i.
Lic. No.
Lic. No.F o 7 -6;
Engineer's E-mail Address
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161 Telephon
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Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $