HomeMy WebLinkAboutX2019-3650 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q
F Comm'I f)� Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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(- Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire F_ Liq F Landslide [_N/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)[_
Valuation $
Material/Labor
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OWNER'S NAME Last LAI
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last I- `r ��/
First
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �First `1-z__ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last S_Q 1K\ sk`
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Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY 6A1_ 4l )eS CNCUK` j� Lic No. *1z%2 Class IBROO
Contractor's Address
Contractor's E-mail Address
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city = 1 State Ick
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. 'Y Z.�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $