HomeMy WebLinkAboutX2018-0537 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding Grading
j—Drainage (�[Elec fSC4lech
`FFlood
Plum cu yd cut Cu Vd Fill F
'Project Address (Not mailing address) F_
F- Fire r Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use F—ConstType
ryIGIFL O&R 1�
# Stories #Units (if Res)l-
Valuation $
--
New/Add SFI
Remodel SFr— Garage/New/Add I r
Material/Labor
i
OWNER'S NAME
Last
Firstl
Owner's Address
Owners E-mail Address
i
City �
_ State _
Zip I Telephoner —
APPLICANT'S NAME
Last I
First 5TEIE
Applicant's Address
Applicant's E-mail Address
2 ?AuAGa
SiffEN_S*�tQl�ltelitZE�rs.C°�1
City State Il/"�-
Zip pli�SC Telephonel 141-(,77� ,1301
_.ku40 E v
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designers Address
Architect/Designers E-mail Address
City
State F--
Zip [_ Telephoned
ENGINEER'S NAME
Last
r-�—
First Lic No.'i,
Engineers Address
Engineers E-mail Address
City
State
Zip Telephoned
CONTRACTOR'S NAME/COMPANY LicNo. �—tIass�—
Cj2�65
Contractors Address
Contractors E-mail Address
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City �(7C.�� _�.�%
State C�
Zip.-gZ�Z(P Telephone 'M—4_ Zip
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. �SJ /
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK NO.
PLAN CHECK FEES $