HomeMy WebLinkAboutX2016-1458 - Permit ApplicationFruit Erm Worksheet for Combo Building & Solar Permit Application SIZE%
Comm'I Residentialr City of Newport Beach - Building Division
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Description of Work
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# Stories # Units (if Res)s
Valuation $
Material/Labor
New/Add SFs-- Remodel SFF—Garage/New/Add
OWNER'S NAME Last
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Owner's Address Owner's E-mail Address
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APP 'S NAME Last S 0 0 L d First ��
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Ap7ftplica Address
_ Applicant's E-mail Address
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City /J_ jr �. State F � Zip F_ Telephone 4 3
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ARCHITECT/DESIGNER'S NAME Last e'er / _ (� . /' First O( .. yI j{- Lic. No.
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ArchitercUDesigner's Address Architect/Designees E-mail Address
city State
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ZIP r`-_` Telephone[ —
ENGINEER'S NAME Last j First! /'C-1.1 t- Lic Nof —
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAMrEXOMPANY Lic No. — ClassFl
Contractor's Address Contractor's E-mail Address
City I State F_ Zip F Telephoner
SETBACKS REAR SETBACKS FRONT PERMIT NO. b
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $