HomeMy WebLinkAboutX2019-3918 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ®R'l—,
City of Newport Beach - Building Division(— Comm'I F_ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
( Building r Grading [—Drainage r Elec ( Mech r- Plum Cu vd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood i` Fire F' Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use Const Type
t♦ Stories q Units (if Res)
Valuation $
Material/Labor
New/Add SF�� Remodel SFF— Garage/New/Add
OWNER'S NAME Last._ First
Owner's Address Owner's E-mail Address
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City State ( Zip FR ,u TelephoneF—
APPLICANT'S NAME Last _ First
Applicant's Address Applicant's E-mail Address
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City R�_ State jr Zip C-/��.� Telephone F402%w —
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ARCHITECT/DESIGNER'S NAME Last �— First F_ Lic. No.
ArchitecNDesigner's Address Architect/Designer's E-mail Address
City State Zip TelephoneF—
ENGINEER'S NAME Last First j N Lic No.
Engineer's Address Engineer's E-mail Address
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City State Zip �� ,-� Telephone g7—//'e6
CONTRACTOR'S NAME/COMPANY<«�� Lic No. 1411/9111Class
Contractor's Address Contractor's E-mail Address
Cityv✓. .:,.J , State Zip G�-�--73� Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. X 7-011 `
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S