HomeMy WebLinkAboutX2019-0620 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL J (p
❑ Grading
Address (Not
Description of Work
New/Add SF
1 ainage ❑ Elec [] Mech ❑ Plum cu Yd cutl Cu Yd Fill
III___ C
address) ❑ Flood [:] Fire ❑ Liq ❑ Landslide [—JN/A Floor Suite No
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Vt tVZLII6 Use I ; ConstType�—'i
I
�I Oo StoriesC # Units (if Res)C
Remodel SF
OWNER'S NAME Last
Owner's Address
_4-> 6,__ x1 Pn v� r a jet
F�
City (;Paoo , D2� t /� ( State
APPLICANT'S NAME Last
Applicant's Address
i
I
City State F
Valuation $
age/New/Add Z Material/Labor Y "w
First
Owner's E-mail Address Cr-C S C. rr I
2M
First
`7417-
Applicant's E-mail Address
Zip �,,� Telephoned —JI
ARCHITECT/DESIGNER'S NAME
Last HA LDdJ�) I First Lic. No. —I
Architect/Designer's Address
71 wl ��� ;
City State I
Architect/Designer's E-mail Address
l��ct C'vy l t LG s' � x ('zz P -Aet
Zip if Telephone ` _ 55
ENGINEER'S NAME Last -� First (-' Lic No.F
r�
Engineer's Address
City State
Engineer's E-mail Address
� G n r
Zip Telephone
CONTRACTOR'S NAME/COMPANY — Lic No. F Class
Contractor's Address
City _ State Zip
SETBACKS REAR
SETBACKS FRONT
Contractor's E-mail Address
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $