HomeMy WebLinkAboutX2019-1428 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ow
j- Comm'I j Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r- Flood
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Description of Work
Use Type I
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# Stories #Units (if Res)
Valuation $ 0"New/Add
Material/Labor[4�1
SF��. Remodel SF Garage/New/Add
OWNER'S NAME Last
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First —"
Owner's Address
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Owner's E-mail Address
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City N I, / y
State .. Zip � Telephone[g4i j
APPLICANT'S NAME Last
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First Y�/ ,i l
Applicant's Address _ '(
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Applicant's E-mail Address
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City r
State C Zip
[ C 3 Telephone e
ARCHITECT/DESIGNER'S NAME
Last
LicNo.
First 6,6
Architect/Designer's Address
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Architect/Designer's E-mail Address
City �
State Zip (� Telephoned—.
ENGINEER'S NAME Last
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First ��,Cr—�u Lic. No. G�0
Engineer's Address
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Engineers E-mail Address
City ; 1 rt,,,, 4
State �� Zip
R Telephone iL - 6?7�
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CONTRACTORS NA�1MaE`/COMPANY ��
Lic N/o._IClass
Contractor's Address
Contractor's E-mail Address
City
State ' Zip
�� Telephoned
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO. r
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.p3
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $