HomeMy WebLinkAboutPV2019-176 - Permit ApplicationPV WI"t l -TIN
PnntFom Worksheet for Combo Building &Solar Permit Application 01 Sqil,�❑ Comm'I ❑'residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding ❑ Grading ❑Drainage []Elec ❑ Mech ❑ Plum Cu vdCut
171 Cu Yd Fill 17
Project Address (Not
mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide []N/A - Floor Suite No
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Description of Work
Use' Const Type
# Stories r` # Units (if Res[]
LjLj 9
J1 d
New/Add SF Remodel SF Garage/New/Add
Valuation $
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Material/Labor F
OWNER'S NAME
Last` I First S CIa
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Owners Address
Owner's E-mail Address
City �1;��.,rK:,vT ti♦';P%�tr^h
�.. State Zip� Telephone'�I(j—;,.- I$'
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APPLICANT'S NAME
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