HomeMy WebLinkAboutX2018-2884 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application
r. Comm'I k/esidential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Po'<uilding F_ Grading r-.Drainage r.,Elec F,Mech rl, Plum CuYdCut F_ CuYdFill I
Project Address (Not mailing adc(resss)r; Flood r. j Fire F., Liq ri Landslide_N/A Floor
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Description of Work n/ a C/ S/Ory JL�;DPAAUse
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�onst Type
# Stories�11
# Units (if Res)F
A Ate
Valuation $
Material/Labor
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New/Add SF�; Remodel SFF—I Garage/New/Add—I
OWNER'S NAME Last O I First .I
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Owner's Address Owner's E-mail Address
City State I Zip —�I Telephoned
APPLICANT'S NAME Last jZ-U/-% X First I C A `
Applicant's Address Applicant's E-mail Address
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City ,)AL,60A SL/1a.,.{/7 ' State I `A i Zip ` 4 z —Telephone
ARCHITECT/DESIGNER'S NAME Last ��i First AAID Lic jj�� Zu '�i
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Architect/Designer's Address Architect/Designer's E-mail Address /
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City II State �� Zip ���I Telephone
ENGINEER'S NAME Last Firs[ F Lic. No.
Engineer's Address Engineer's E-mail Address
City , State F Zip F Telephoned
CONTRACTOR'S NAME/COMPANY % Lic. No. Class
Contractor's Address Contractor's E-mail Address
City State F Zip F Telephone .
SETBACKS REAR SETBACKS FRONT PERMIT NO. X1016 b%4
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $