HomeMy WebLinkAboutX2018-3712 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o49EyPom
~ Comm 1 r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL .s
("'Building r Grading
(-"Drainage �__: Elec --+�-Pc plum CuYdCut r CuvdFill
Project Address (Not mailing address) (— Flood r Fire F Liq r Landslide rN/A Floor Suite No
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Description of Work
Use F—ConstType
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# Stories #Units (if Res)
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V nati)or
ateri
New/Add SF�
Remodel SF 4-6-Garage/New/Add �_—
OWNER'S NAME
Last 7�,tJ�¢ First %jet {
Owner's Address
Owner's E-mail Address
City
State Zip F--_. TelephoneF_
APPLICANT'S NAME
Last I , * First DAy;,E,/
Applicant's Address
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Applicant's E-mail Address
7Ye) Ili�-
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E City � y�
State 144 Zip 9- ZgWS Telephone 7c(_��!%�� 6 6
ARCHITECT/DESIGNER'S NAME Last F_ First F_ Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City F_
State F_ Zip F— Telephoner---.--.- LL
ENGINEER'S NAME
Y
Last First Fu---..._ ---_ Lic No.F--
Engineer's Address
Engineer's E-mail Address
City �
State F_ Zip
CONTRACTOR'S NAME/COMPANY Q GJ..� �a y is No. '�/ -/Tq Class
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Contractor's Address
Contractor's JE(Address
City
State r�_,y -- Zip Zg6y lephone� 11 (J
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES