HomeMy WebLinkAboutX2018-0464 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r- Comm'I IVResidential City of Newport Beach'- Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF+SUBMITTALr
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Description of Work t + Use F Const Type;
*R,_'l Onits (if I
Valuation $ ✓
New/Add SF sf r Remodel SF G Qp 5Garage/New/Add -, Z 8 ; Material/Labor �)
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GWNER'S'NAlfilq9 Last XAOtA First _Grr 1"1AGEt�A�NG
Owner's Address Owner's E-mail Address
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City tya �J�'i EIGp State e Zipofj Gv Telephone ri49
APPLICANTS NAME Last A✓moi First +�lilld/ryl
:Applicant's Address Applicant's E-mail Address
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City .&wP®F7+ [j ,ob: State CM ZIP fiC,(t9 Telephone ("j47. `& •-330
ARCHITECUDESIGNER'SNAME Last Gpv1N� First ,� Lic: No.36Iro�
ArchitectlDesigners Address Architect/Designers-;E-mail Address
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City we vft:�'r OV}e({ State C/q Zip Qy Telephone /Q-. q" �, 3 J1 {j
ENGINEER'S NAME Last First ?�)I47 ( of
Engineer's: Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY /Jv, I Lic. No. � �Class
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Contractor's Address V Contractors E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. l�J
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE' DEVELOPMENT NO PLAN CHECK FEES $ ; Z L+