HomeMy WebLinkAboutX2018-1616 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
Cityof Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL pr"
Building n Grading
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Project Address (Not mailing address) Flood f—I Fire �I, Liq F] Landslide I—IN/A Floor Suite No
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Description of Work
Use Const Type
% � /� �.,/�
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# Stories # Units (if Res)❑
Valuation $
Material/Labor
New/Add SF
Remodel SF Garage/New/Add F�
OWNER'S NAME
Last First
A,dddrresss`
bwtne s E-Oil A dre
rOwner's
City State ® Zip Telephone[
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State Zip Telephone 7 `C 2,
ARCHITECT/DESIGNER'S NAME Last First Lic. No. /
Designer's Address
OF
Architect/Designer's E-mail Address
City f — _
_ _ State F-77 Zip F------7 Telephone
ENGINEER'S NAME
Last First F Lic. No.1
Engineer's Address
Engineer's E-mail Address
City(
State zipF Telephone
CONTRACTOR'S NAME/COMPANY 01 Lic. No. F Class
Contractor's Address
Contractor's E-mail Address
City
State J Zip—� Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO. / (J
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 2— -- �-CJ
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $