HomeMy WebLinkAboutX2019-3896 - Permit ApplicationSao l sA�.[,v I not T
PnntForm °" Worksheet for Combo Building & Solar Permit Application
❑ Comm'I ❑ Residential City,of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-]Building ❑Grading ❑Drainage ❑Elec ❑Meth [7 Plum cu Yd Cut E7 Cu Yd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq.0 Landslide ❑N/A Floor Suite No
onI
Description of Work
Use I Const Type I
# Stories❑ # Units (if Res)
Valuation $
Material/Labor
New/Add SF F7771 Remodel SF 17:7771 Garage/New/AddF—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State E:71 Zip [� Telephoner
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State Zip [::::7] Telephoned
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address Engineer's E-mail Address
City State Zip .. Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address - Contractor's E-mail Address
City �— State zip I Telephone��
SETBACKS REAR 0' SETBACKS FRONTy PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $