HomeMy WebLinkAboutX2019-0001 - Permit Applicationfto P),f BE
Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division )( ?OLD - tto Re
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB�M�IT�pTAA/LL
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Description of Work AA t)PAIr Use C ConstType
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APPLICANrSNAME Lastl r/IJLOr
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Applicant's Address
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Applicant's E-mail Address �"
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ARCHITECT/DESIGNER'S NAME Last Lcts4er First I 1�06 r Lic.No. C- ja37L� ^
Architect/Designees Address
ArchitectlDesigners E-mail Address
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ENGINEER'SNAME Last
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Engineer's Address
Engineers E-mail Address
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CONTRACTOR'S NAME/COMPANY40po Vr orO j ;;-k, Lic.No. �-2/si Class
Contractor's Address IF 41,,NNEY12t-r- "1�t /Z Contractor's E-mail Address
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SETBACKS REAR 1 Qr SETBACKS FRONT Q PERMITNO. X 70I9 " UC�U I
SETBACKS LEFT ` SETBACKS RIGHT
PLAN CHECK NO. QOb Z - 7_0 q
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USE ZONE f `--" DEVELOPMENT NO
PLAN CHECK FEES $