HomeMy WebLinkAboutX2021-2014 - Permit ApplicationPrint Form Worksheet 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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Description of Work
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Valuation $
Material/Labor Loft
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OWNER'S NAME Last (;J`"F4Ziv �1�
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last �
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/ SIGN NAME Last �,
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First
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Architect/Designer's Address
Architect/Designees E-mail Address
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ENGINEER'S NAME Last „��,A
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Eng•i-n-eeer's Address
Etnngineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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REAR SETBACKS FRONT
PERMIT NO.4_{ETBACKSLEFT
[9ETBACKS
SETBACKS RIGHT
PLAN CHECK NO. `l 00 •VO9-1
SE ZONE DEVELOPMENT NO 'D2a�.► • 04(5 PLAN CHECK FEES $
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