HomeMy WebLinkAboutX2017-3039 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F Comm" (� Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
ISBuilding F- Grading
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lProject Address (Not mailing address) [ Flood I- Fire F_ Liq F- Landslide CN/A Floor Suite No
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Description of Work
Use g')JIA ConstType R
# StoriesT, # Units (if Res)
Valuation
Material/Labor CT
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New/Add
Remodel SF I 3Z Garage/New/Add F
OWNER'S NAME
Last �t� First i70P_oT
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
Last First 3�OA.)
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last �,�Ni (GfI'S.. -- --- -- First M kjJ :-_ f A _ Lic. No. r —
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME
Last Gpp�[e First CotJW Lic.No. S$Zi
Engineer's Address
Engineer's E-mail Address
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State IG�i} Zip �� Telephone Si 7_
CONTRACTOR'S NAME/COMPANY Ca—lQ.Q1tLic. No. _ (Gj Class
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. Y`�I1I� • �OBR
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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