HomeMy WebLinkAboutX2019-0005 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F_ Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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r"Building F Grading r-Drainage C Elec 1 Mech j- Plum Cu Yd Cutr�^ Cu Yd Fill
Project Address Not mailing address) F- Flood F- Fire F- Liq Landslide ! N/A Floor Suite No
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Description of Work _
Use Const Type
#Stories- #Units (if Res)'
Valuation $ �VP
Material/Labor]
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New/Add SF[ Remodel SF�® Garage/New/Add ��
OWNER'S NAME Last V 'al> First
Owner's Address Owner's E-mail Address
City �* .��Z .AT--�.' State ZIP'l Telephone,)_-} _
APPLICANT'S NAME Last Yam' w First
Applicant's Address Applicant's E-mail Address
City vs State Zip I Telephoner--
ARCHITECT/DESIGNER'S NAME Last First r® F_i I Lic. No.
Archite_�t/Desi nets Address ArchitecUDesigners E-mail Address
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City 4'� 1`�''i'U� State Zip Telephone
ENGINEER'S NAME LastL--------First jV/V--1C=- Lic. No.{
Engineer's Address / Engineer's E-mail Address
City State Zip i Telephone��
CONTRACTOR'S NAME/COMPANY ` i Lic. No. i S i l c z,�, Class ' II
Contractor's Address Contras or's E-mail Address
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17& i j _ �C%LC4 ,C
City State ' ZiPI q l Telephone)'
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1 (� — C,
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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