HomeMy WebLinkAboutX2018-0157 - Permit Application (2)Print Form— Worksheet for Combo Building & Solar PermnitA licati/on ���E��R.m
Comm'I Residential City of Newport Beach - Building Division )j /`)�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI CCC
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Description of Work
Use F—Const Type F
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OWNER'S NAME
Last%L! cL�f
First
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Owner's Address
Owner's E-mail Address
City
State F Zip F Telephoned
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City �
State F_ Zip F_ TelephoneF_
ARCHITECT/DESIGNER'S NAME Last First FF_
Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City
State Zip F Telephone
ENGINEER'S NAME
Last First Lic Nol
Engineer's Address
Engineer's E-mail Address
City
State Zip F Telephone)
CONTRACTOR'S NAME/COMPANYLic. No. (I Class
Contractor's Address
Contractor's E-mail Address
City
State F Zip F Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $