HomeMy WebLinkAboutX2018-3659 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
j— Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building F_ Grading (-Drainage r` Elec F Mech F" Plum CuYdCut F CuydFill �
ProjectAddress (Not mailing address) F_ Flood F- Fire F- Liq j— Landslide f N/A Floor Suite No
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VG V� 5 2 ��
1/F/ �n ✓
Description of Work
Use �`� ConstType
Stories #Units (if Res F_
Valuation $
Material/Labor f 2
New/Add SFF__ Remodel SF(—
Garage/New/Add r —
OWNER'S NAME Last n��tN G......,1��
Ovf Vn�'t
First
Owner's Address
Owner's E-mail Address
City State F_ Zip I Telephone® --
APPLICANT'S NAME Last
First
Applicant's Address
i
Applicant's E-mail Address
i
City State f �
Zip �-- Telephone
ARCHITECT/DESIGNER'S NAME Last F—
First— Lic. No. F_
ArchitectlDesigner's Address
r
Architect/Designer's E-mail Address
City Fs State F
Zip �� Telephone[ ---
ENGINEER'S NAME Last �
First
UUU J
Engineers Address
Engineer's E-mail Address
City State
Zip F— T lephone��
CONTRACTOR'S NAME/COMPANY ,e. Lic. No. �Class
Contractors Address _
I C v
AV
C rector's E-mail Address
_
City ��r/Gi; Y;/� State
U
Zip Telephone Telephone '911�1Gj
Q211y
SETBACKS REAR SETBACKS FRONT
PERMIT NO. xZDI I� -: j67s1
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. �,5ol
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $