HomeMy WebLinkAboutX2021-0190 - Permit Application (2)IL
Print Form ., Worksheet for Combo Building & Solar Permit Application
{�, Comm'I r; Residential ty of Newport Beach - Building Division
NOTE: PiLAN HECK EES DUE AT TIME OF SUBMITTAL- - •_olq 0
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OWNER'S NAME Last
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APPLICANT'S NAME Last I
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Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last_ _ First - '
Lic. No.
Architect/Designer's Address
ArUDesigner's E-mail—�
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State Zip Telephone
ENGINEER'S NAME Last ��
First Lic. No,[-T$O�S �
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address Contractor's E-mail Address
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SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $