HomeMy WebLinkAboutX2019-0455 - Permit ApplicationPrint Fort„ Worksheet for Combo Building & Solar Permit Application
r- Comm'1 (-✓FFesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) I- Flood F_ Fire r' Liq 1W Landslide Floor Suite No
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Description of Work
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Valuation $
Material/Labor V3Q9
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
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Architect/Designer's Address
ArchitecUDesigner's E-mail Address
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ENGINEER'S NAME Last
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Engineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
No.gam Class
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Contractor's Address
Contractor's E-mail Address
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CityI I&e*A-
State Zip g2821 Telephone FrI,lq) yy._�oC3D
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SETBACKS REAR 101
SETBACKS FRONT dot PERMIT NO.
SETBACKS LEFT S t
SETBACKS RIGHT S t PLAN CHECK No.y%+,?AI
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $