HomeMy WebLinkAboutX2019-3699 - Permit ApplicationPrint Form W � sheet for Combo Building & Solar Permit Application o4
IFComm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
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Valuation $
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OWNER'S NAME Last,
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last - First,9
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Last -FA Z First .,Jc%S�_ Lic.No.
ArchitecVDesigners Address
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Architect/Designer's E-mail Address
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ENGINEER'S NAME Last
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�S Engineers E-mail Address
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CONTRACTOR'S NAME/COMPANY
Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City
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SETBACKS RE \�
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SETBACKS FRONT t_1 ^ �LVC(j PERMIT NO.
SETBACKS LEF
SETBACKS RIGHT �.�jT9 PLAN CHECK NO. `` f
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USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ `