HomeMy WebLinkAboutX2015-3666 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'Iing Division
Residential City of NewportNOTE: PLAN HECK F ES DUE each -AT THE OF SUBi'NITTAOL� / m
ilding I— Grading rDrainage frElec F191ech d`JPlum cued cutI Cu Yd Fill l
Project Addre^ss� (Not mailing address) d— Flood j` Fire r Liq r Landslide k/A Floor Suit
Description of Work
Use � � Const Type v%3
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# Stories #Units (if Res)
Q
Valuation $
Material/Labor
New/Add SF //G Remodel SFr Garage/New/Add (_
OWNER'S NAME Last W1,4w N First
Owner's Address
Owner's E-mail Address
City ENV/ State
/ `
Zip Telephone �3
APPLICANT'S NAME Last ��K7l�
First
Applicant's Address
Applicant's E-mail Address
City
/��Cy C State I C
Zip q Telephone
/
ARCHITECT/DESIGNER'S NAME Last ��`� First �/ / Lic%No
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
Gdco1C. NET
city UCp G yl, State
Zip 9��? q Telephone % 9¢�¢
ENGINEER'S NAME Last kWtV 4iWO
First �O�W/ L i c. N '
EngineersAddress
E-mail Address
City
/r���TB
/Engineer's
Zip Telephone /4
�n N 00tate C�
ia
CONTRACTOR'S NAME/COMPANY
Lic. No. Class
Contractor's Address
Contractor's E-mail Address :.
City �— State
Zip Telephonel
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
s
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