HomeMy WebLinkAboutX2015-2920 - Permit ApplicationVJy
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Print Form
Worksheet for Combo Building & Solar Permit Application
Comm'I (L,4esidential
City of Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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;i'�vtiruilding r- Grading
r"Drainage 'I%Elec rfVlechjTPlum cu yd cut' Cu Yd Fill
Project Address (Not mailing address)' 1- Flood (- Fire r' Liq Landslide rN/A Floor- Suite No
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Description of Work
Use,
I" J Const Type I'� ✓ r ��
d K a u/
# Stories # Units (if Res)s
New/Add SF 7 j jJ
Remodel SFGarage/New/Add
Valuation $
Material/Labor
OWNER'S NAME
Last First
f.
`. Owner's Address
Owner's E-mail Address.
City
State F777 Zip I Telephoner—,
APPLICANT'S NAME
Last �- First
" Applicant's Address
Applicant's E-mail Address
City � :
State ��" Zip..
Telephone
ARCHITECT/DESIGNER'S NAME Last"
First F Lic. No.
<ArchitecUDesigner's Address
.:. Architect/Designer's E-mail Address
City—i
State �— Zip
r - Telephoned
ENGINEER'S NAME
Last First Lia No.F—
Engineer's Address
Engineer's E-mail Address
City _
i
State Zip, TelephoneF
CONTRACTOR'S NAME/COMPANY ' Lia No. r Class
Contractor's Address
Contractor's E-mail Address
Gity
Sta"�
te — Zip:— T e on
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SETBACKS
REAR
SETBACKS FRONT - PERMIT NO: " -
SETBACKS
LEFT
SETBACKS RIGHT '-PL-AN'CK'NO; "
USE ZONE..: _
DEVELOPMENT NOS PLCHECK CHECK FEES $