HomeMy WebLinkAboutX2020-1284 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application o4?g"°�
r, Comm'lY Residential City of Newport Beach - Building Division �lZo� ^ hp o a
NOTE:. PLAN CHECK.FEES DUE AT TIME OF SUBMITTAL n r as+'
viH <Flo�or, Suite No
City'State
Zip
s
Telephone
M ii t 9 q
ARCHITECT/DESIGNER'S NAME Last First
' Lic. No. ,
_
Arch Designees- Address
Architectlpesigner's-E-mail Address
City— j State J
i
zip
TelephoneTelephone
ENGINESS NAME' . Last First
�� Lic. No.
Engineer's Address `
Engineees E-mail Address
I
�
City State--
Zip
Telephpne
CONTRACTOR'S NAME/COMPANY 1J a/
t ^-
Lic. No.. Class,
�, c y
Contractor s Addres
..
Contractor's E-mail Address
�7
/r_ l4tYfAJd.db _
rG p+.:�td! r )X 4 �.
City / V / Z -c State
Zip
Telephone Y9 7_7'
SETBACKS REAR: SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $