HomeMy WebLinkAboutX2018-0406 - Permit ApplicationPrint Fora Worksheet for Combo Building & Solar Permit Application ��ew °^
dComm'I r Residential City of Newport Beach - Building Division (� �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL<�.o•�°
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Description of Work �o
Use , a Const Type P�
# Storiesw # Units (if Res)F7
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Valuation $
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rial/LaborNew/Add
SFFRemodel SFl I Garage/New/Add
OWNER'S NAME Last— First l � t oPF-i� Ctk iLAID
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last lFirst
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Applicant's Address Applicant's E-mail Address
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City C�(ton pv L hKt12 _ , State !i Zip Q Z� Telephone aKa
ARCHITECT/DESIGNER'S NAME Last LAI qj PiW First 5&0 -TT _-, Lic. No. G j
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Architect/Designer's Address Architect/Designer's E-mail Address
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State --._
City � Pc-__tifit. (hy�r, �!, Zip Telephone
ENGINEER'S NAME Last �— First Lic. No.
Engineers Address Engineer's E-mail Address
City _- '', State F Zip Telephone
CONTRACTOR'S NAME/COMPANY �/t A'�y- / -- Lic. No. 7 Class
Contractor's Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. S' D y0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $