HomeMy WebLinkAboutX2019-3355 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application ��EWP°Rr
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City of Newport Beach - Building Division
F Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 0�4-
F_ Building F Grading
(-`"Drainage F_ Elec F_ Mech INPIUM CuYdCut CuYdFill
Project Address (Not mailing address) f Flood f— Fire [- Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use ConstType F
7 'I o 0 1
+
i 1'. L- t
#Stories: #Units (if Res)
Valuation $ ��� trn
Material/Labor ( ow • t1 `�
New/Add SF
Remodel SF Garage/New/Add
OWNER'S NAME
Last U .4l t�First
Owner's Address
Owner's E-mail Address
APPLICANT'S NAME
Last �O�I P Vj Firsts
Applicant's Address
Applicant's E-mail Address
1 � �� � Nih 11-�r2�� �` � (�C�! U�� �-� l�J�/utC' . Ltfi�✓►
City �[ �/�_
� State C Y� Zip L� 2 & C.7 Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F__
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City
State Zip F Telephoned
ENGINEER'S NAME
Last First F Lic. No.r
Engineer's Address
Engineer's E-mail Address
City
State F__ Zip F_ Telephones
CONTRACTOR'S NAME/COMPANY ti��, nn �` Lic. No. F Class F
Vvl�li.
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip �� Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $