HomeMy WebLinkAboutX2017-3619 - Permit ApplicationX.4017- 36/9
Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach -Building Divisionc(rop "
.NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing [ Flood ❑Fire Liq Landslide F �N/A Floor Suite No
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Description of Work
Use F7ConstType
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# Stories : # Units (if Res)
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De- /
Valuation$
Material/Labor)
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New/Add SFI Remodel SF Garag a/New/Add
OWNER'S NAME Last YcXc S.Ar_ V uI k
Owner's Address Owner's E-mail Address- -
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City ( � I State 'Zip Telephone __,D_ —
APPLICANT'S NAME Last � t,0- J First N(qs
'Applicant's Address Applicants E-mail Address
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City State F __7 ZipI Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designers Address Architect/Designers E-mail Address
City�State � Zip q Telephone aL-1q- Vis;
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ENGINEER'S NAME Last First) Lic. No.
Engineers Address Ins Engineer's E-mail Address^
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City State Zip J, Telephone��
CONTRACTOR'S NAME/COMPANY Lic. No. �uko� Class
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- ContractorsAddress. Contractors E-mail Address
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City _- state r Zip F Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT - PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $