HomeMy WebLinkAboutX2019-2030 - Permit Application[�.Print Form Workslie'et for Combo Building & Solar Permit P4 cation
F7 comm,i Residential City of Newport Beach - Building Division
r NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F,, Flood F-, Fire F-1, Liq F-, Landslide [—.N/A Floor Suite No
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Description of Work Use Const Type
# Stories'
#Units (if Res)F,
Valuation $
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New/Add SF �Rernod Ige /New/Add Material/Labor
OWNER'S NAME Last First JW
Owner's Address Owner's E-mail Address
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City State r- � -1t Zip Telephone
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APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
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Citj;�A loj*� State Telephone
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ARCHITECT/DESIGNER'S NAME
Last First LI c. No.P
Architect/Designer's Address Architect/Designer's E-mail Address
City State zip Telephone
ENGINEER'S NAME Last �Loo,4-7 First Lic. No.1 J22
Engineer's Address Engineer's E-mail Address
City State Zip Telephone
Lic.
CONTRACTOR'S NAMEXOMPANY 0. Fst 3,R�- Classer FT
Contractor's Address Contractor's E-mail Address
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City State Zip Telephone
REAR
LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK No. 411
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DEVELOPMENT N5 PLAN CHffCK FEES $
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