HomeMy WebLinkAboutX2016-0564 - Permit Application�26% coa_� �\l
0338-2016
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F00.NP
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Description of Work
Use ConstType�
# Stories'®® # Units (if Res)'
—
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Valuation $
New/Add SF Remodel
SF! Garage/New/Add
Material/Labor'
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OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
i
City i
State Zip Telephone,
APPLICANT'S NAME Last
First 1,
Applicant's Address
Applicant's E-mail Address
— 1
i
City
1
State Zip Telephone-
ARCHITECT/DESIGNER'S NAME
Last - First Lic. No.
Architect/Designer's Address
— Architect/Designer's E-mail Address
1
1
City
State Zip Telephone,. c
ENGINEER'S NAME Last
First Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip ; Telephoner
CONTRACTOR'S NAME/COMPANY
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Contractor's Address I Contractor's E-mail Address
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City CIO .- cam,
State I Zip Uj ( �� Telephone ,7 N
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
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DEVELOPMENT NO 1- LAri FEES