HomeMy WebLinkAboutX2019-3892 - Permit Application9
Print Form Wor eet for Combo Building & Solar Permit Application
F_ Comm'I J_�. Residential
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of Newport E lding Division
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Building (` Grading
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Project Address (Not mailing dress) ly Flood Fire Liq Landslide f_N/A Floor Suite No
Description of Work
Use Const Typel('�_
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# Stories # Units (if Re l
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Valuation $
Material/Labor
New/Add SF
Remodel SF Garage ew/Add
OWNER'S NAME
Last =' , First
Owner's Address
Owner's E-mail Address
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City State
/li�U-t✓ . rs,e? �,g� Zip Telephon _ ✓�f�,
APPLICANT'S NAME
Last _=;'� a��5 G�:,�eJ:= First
Applicant's Address
Applicant's E-mail Address
City
State F_ Zip �� TefephoneF
ARCHITECT/DESIGNER'S NAME Last 4,"�� First Lic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City to R �..
State �1 Zip c(G cTelephone
ENGINEER'S NAME
Last j' y�L� First Lic. No.
Engineer's Address
Engineer's E-mail Address ....
City
State F_ Zip Telephone
CONTRACTOR'S NAME/COMPANY
�_ /Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City �
State Zip F_ Telephonel�
SETBACKS REAR
SETBACKS FRONT // 7 PERMIT NO. W-6 ..r•
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $