HomeMy WebLinkAboutX2019-2440 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application 01.
F_ Comm'I j Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
f—Building F -Grading F -Drainage r"Elec (—Meth
Plum Cu YQ Cut CU Yd HII
Project Address (Not mailing address) F Flood F_ Fire i"tiq i` Landslide FN/A Floor Suite No
Description of Work
Use I � ConstType FY�,
p Stories? # Units (if Res)
Valuation $
Material/Labor 15k
'?Remodel
New/Add SFF— SF Garage/New/Add —!
OWNER'S NAME LastC�J�L�J First _..
Owner's Address Owner's E-mail Address
city State �� : Zip / �a�v° v Telephoner—
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elephoneAPPLICANT'S
APPLICANT'SNAME' Lasts
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Applicant's Address /
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City nF^ _ J State�/w
Applicant's E-mail Address /
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ZipF)/Telephone
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. F_—,,
Architect/Designer's Address -
Architect/Designer's E-mail Address
City �. State �—
Zip I Telephoner
ENGINEER'S NAME. Last �Firstil
Lic. No.y��:v7q�j-
Engineer's Address
Engineer's E-mail Address
OVY iti%.. K��� A�� X110;
City ._, _ State ,-1?4-
Zip G�.�&, .� Telephone V71
CONTRACTOR'S NAME/COMPANY / o Lic.No. �!l��IG Class(J
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/E-mail
Contractor's Addy,{rreesss )
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Contractor's Address
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Zip cd 7s�i Telephone CI o, r/ Cf -e' _ ed r�ir;� 6i
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO -
PLAN CHECK FEES $