HomeMy WebLinkAboutX2018-1817 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
rI COmm'l r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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jJBuilding � Grading []Drainage Elec
❑ rjMe" Plum Cu Yd Cut
...JJJ Cu Yd Fill
Project Address (Not mailing address) � Flood C Fire [ Liq n Landslide DN/A Floor J
b V ICr f CA Suite No
Description of Work
New oC 1C V!8'l�k^ a Use Const Type F
i—vv— — #Stories # Units (if RRes)F--J
New/AddSFF___7— Remodel SFValuation $ Garage/New/Add I ;�dp or) e1
Material/Labor f
OWNERS NAME
Lastl�lci��a,
.f s%' _— —I First ton
Owner's Address
Owner's E-mail Address '
City
State cC Zip Telephone—�
Applicant's Address
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— __�
Applicant's E-mail Address
i �""""'�•-�._ ate_
J State CCA
Zip ca7oT Telephone
ARCHITECT/DESIGNER'S NAME
-
—
Last First
Architect/Designer's Address
— ® Lia No. F
Architect/Designer's E-mail Address
City--
I State------
Zip Telephoned
ENGINEER'S NAME Last
F
First �I Lic. No.
Engineer's. Address
— _-�
-:Engineer s E-mail Address -
City
- --_—.
State
—� Zip Telephone
CONTRACTOR'S NAME/COMPANY
�V
Lic. No. g Class t c
�
-Contractor's Address
__
—
�
Q
Contractor's E-mail Address
City
F5 6r 1_..---
State Zip ——
Pari Telephone
SETBACKS REAR
SETBACKS FRONT-
SETBACKS LEFT
SETBACKS RIGHT
_ PERMIT NO. i , `00
H E
USEZONE
PLAN CHECK NO. r
DEVELOPMENT NO
PLAN CHECK FEES $