HomeMy WebLinkAboutX2020-0696 - Permit Applicationw/ -U -'U(0`-1u/
Print Form Worksheet for Combo Building & Solar Permit Application DoCi3�
F Comm'l r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood f Fire F- Liq F_ Landslide FN/A Floor Suite No
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Description of Work
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Valuation $
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Remodel SF F_ Garage/New/Add
OWNER'S NAME
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Owner's Address
Owner's E-mail Address
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APPLICANTS NAME
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last ( First ( l,� v t
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Architect/Designer's Address1
Architect/Designer's. E -mail -Address
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ENGINEER'S NAME
Last First I Lic No.�'
Engineer's Address
Engineer's E-mail Address -
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State Zip Telephoner---
CONTRACTOR'S NAME/COMPANY
Lic. No. F_ Class
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip r� Telephogel----
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==TBACKS REAR
SETBACKS FRONT PERMIT NO.
TBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
I E ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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