HomeMy WebLinkAboutX2016-1812 - Permit Application (2)Print Form' ' Worksheet for Combo Building & Solar Permit Application ��l"
N<Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a`'
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Description of Work \\
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OWNER'S NAME Last C ✓r� C.t\ �` first
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME
Last' 1� First /` Lic. No. i
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Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last
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Engineer's Address
Engineer's E-mail Address
City
State ° Telephone
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CONTRACTOR'S NAME/COMPANY
Lic. No. Class %
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.USE
ZONE
DEVELOPMENT NO PLAN CHECK FEES $ _ i n .2�
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