HomeMy WebLinkAboutX2019-1473 - Permit ApplicationPrint Form 9 Worksheet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division X2a1�j,-��3
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description
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OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State ----
Zip �� Telephoned -'
APPLICANT'S NAME Last C /Pr_C9,
First
Applicant's Address
Applicant's E-mail Address
City State F
Zip Telephone[—
ARCHITECT/DESIGNER'S NAME Last I First F- Lic. No. G I'
Architect/Designer's Address
Architect/Designer's E- ail Address
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City I State F
Zip F Telephone - 6 . J_g�-J�
ENGINEER'S NAME Last p j4liV
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First vL� Lic. No.
Engineer's Address
Engineer's E-mail Address
City State
Zip F Telephone
CONTRACTOR'S NAME/COMPANY y /F
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Contractor's
E-mailAddress
jAddress
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SETBACKS REAR SETBACKS FRONT ' PERMIT NO. 14 73
SETBACKS LEFT �i� SETBACKS RIGHT
PLAN CHECK NO. (i "�&Ot�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ D