HomeMy WebLinkAboutX2013-2126 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division °
F- Comm'I F- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
uilding F Grading F -Drainage r Elec F- Mech IV Plum cuvdCut
. CUYd Fill Imo_
ling address) F" Flood I� Fire I- Liq F- Landslide I -N/A Floor Suite
Project Address QN®t evoael
Work
New/Add SFF�
OWNER'S NAME
Owner's Address
City F�
Remodel SFr --
Last
Use '., ConstType''..
# # Units (if Res
Storiesr� )r
__ -"-6
Garage/New/Add
First
Owner's E-mail Address
— State F Zip � Telephonel--J--�'.
APPLICANT'S NAME Last
Applicant's Address - -
City
State I
'., First - ..
Applicant's E-mail Address ...�
Zip [�: Telephoner�,
ARCHITECT/DESIGNER'S NAME Last,--.__� First F�. Lic. No. r�-.
Architect/Designer's Address - Architect/Designer's E-mail Address
..
City State I--. Zip � Telephonel_._��..,.._,�.�...
��—
ENGINEER'S NAME Last
�. Firstr-�:. Lic. No.F�,.'.
Engineer's Address Engineer's E-mail Address
. _ State �— Zips, Telephone'.
City
CONTRACTOR'S NAME/COMPANY P-01
lit-++-- """ Lic. Nof� Class
Contractor's Address Contractor's E-mail Address
I
_... ..._.._ _ State r—� Zip_'. TelePhone��.
City
SETBACKS FRONT PERMIT NO.
SETBACKS REAR
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO
.----
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ -
-��3 - o332r