HomeMy WebLinkAboutX2018-0767 - Permit ApplicationWorksheet for Combo Building & Solar Per
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB
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Address
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Cu Yd Fill
[N/A Floor Suite No
04 I Use I�0 Const Type
i-StrE / # StoriesFl # Units (if
New/Add SF� Remodel SF Garage/New/Add � 9r'; Material/Labor
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OWNER'S NAME Last L I,', First
Owner's Address s� Owner's E-mail Address
CityState ITT Zip O Telephone qRF(// -Z
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APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
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City ! �I�GO J State �� Zip Cl�( Telephone7/y'�S�Z
ARCHITECT/DESIGNER'S NAME Last W tL�� J First N tC t(j Lic. No C- 3558 �
Architect/Designer's Address Architect/Designees E-mail Address
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City State 7 Zip FTA59 Telephone / OY
ENGINEER'S NAME Last First VJI Lic No. G,SSO�
gineer's Address Engineer's E-mail Address
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State Zip (� Telephone
YS NAME/COMPANY Lic. No. Class)
s Contractor's E-mail Address �� O
ate '...... Zip Telephoned.
SETBACKS FRONT 7 x 1yv9 PECMIT NO. 1z ` 0100
SETBACKS RIGHT 1 PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $