HomeMy WebLinkAboutX2016-4029 - Permit Application (3)Print Form ; Worksheet for Combo Building $Solar Permit Application (rd��°� ai- Comm I [✓ResidentialCity of Newport Beach - Building Division s `
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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OWNER'S NAME Last(
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ARCHITECT/DESIGNER'S NAME Last j _-�; f (\{(4AK First �— Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last f
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Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY I Tf5D
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Contractors Address
Contractors E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. TID
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SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO. p ' (; v I �•
USE ZONE DEVELOPMENT NO
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PLAN CHECK FEES $ �1 S I • �FJ .