HomeMy WebLinkAboutX2019-3731 - Permit Application�C20��3�31
int r 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
❑Building ❑Grading Drainage ❑E c Mach ❑Plum Cu Yd Cut Cu Yd Fill
Project Ad cess (N i i ad r Flood Fire ❑ Li ndslide ❑N/A Floor Suite No
Desc x Wf V10rk .— Use Const Type 171
# Stories❑ # Units (if Res)❑
Valuation �1 j1
New/Ad SFTT I Garag ew/A Material/Labor
bor /Ikll
OWNER'S NAME Last First
Owner's Address wner's E-mail Address
cityI State Zip F_____7 TelephoneF_____�
APPLICANT'S NAME Last
Applicant's Address
City State
First
Applicant's E-mail Address
Zip Telephoned
NAME Last First
ArchitectlDesigner's Address
City State
Lic. No.
Architect/Designer's E-mail Address
Zip Telephoned
ENGINEER'S NAME Last �— First Lic. No.F:___71
Engineer's Address
City State
Engineer's E-mail Address
Zip � Telephoned
/CONTRACTOR'S NAMEKOMPANY 5 501v` OtA+ — Lic. No. Wff
Class
Contractor's Address i Contractor's E-mail Address
4ll11lies i fAAotl C15
City I LOS State ILS Zip /yn - Telephone
SE ACKS REAR SETBACKS FRONT 4) tERMIT NO. 7�-,
SETBAC LEFT SETBACKS RIGHT PLAN CHECK NO. IV7
USE ZONE DEVELOPMENT NO _ __ PLAN CHECK FEES $