HomeMy WebLinkAboutX2019-1052 - Permit Applicationxm(l - l z
Worksheet for Combo Building & Solar Permit Application
7 Comm'I j Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building 1 Grading Drainage 7 Elec Mech j Plum Cu Yd Cut' Cu Yd Fill
Project Address (Not mailing address) 7 Flood
F_ Fire Liq yLandslide F.-N/A Floor M Suite No
Dec�s(Ncrriiip_t(`ion of
Use � � � Const Type e
ri
Work ^ fff�/���pg������_/pYt�( `� /��_���/ }
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LI V �' V V5.�'
'w , `�ri 1_
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# Stories; {? # Units (if Res)!
Valuation $
Material/Labor.
New/Add SF: Remodel SF
Garage/New/Add
-_OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
I
City State i
Zip' Telephone:
APPLICANT'S NAME Last
First 1
Applicant's Address
Applicant's E-mail Address
City State
Zip, Telephone
ARCHITECT/DESIGNER'S NAME Last
First j Lic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
i
City State
Zip Telephone]
ENGINEER'S NAME Last
First Lic. NO.!;.
Engineer's Address
Engineer's E-mail Address
City ! State
i
Zip Telephone,
CONTRACTOR'S NAME/COMPANY
CZ� `Q-c�-
Lic. No. 1 j O1�1 �LjZ Class,
�r� ��c�r1
Contractor's Address
Contractor's E-mail Address
City ! State
Zip 'i Telephone
SETBACKS REAR 110 ETBACKS FRONT
�SdTBACKS
PERMIT NO.
SETBACKS LEFT (� In RIGHT
PLAN CHECK NO. SD�• W ��
J USE ZONE DEVELOPMENT NO
LA1,a i l-it,.t" FEES