HomeMy WebLinkAboutX2018-3026 - Permit Application___Print Form Worksheet for Combo Building & Solar Permit Application
F Comm'I riesidential City of Newport Beach - Building Division 04211_
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Building F Grading
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FDrainage FElec FMech I—, plum Cu Yd cut F_ Cu Yd Fill
Project Address (Not mailing address) f- Flood r Fire r- Liq F'i Landslide FIN/A Floor Suite No
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Description of Work
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N Stories N Units (if Res)s
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Valuation �1
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Material/Labor
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OWNER'S NAME
Last First
Owner's Address
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Owner's E-mail Address
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APPLICANT'S AME
Last First
Applicant's Address
�I Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last First � �. I Lic. No. �',
Architect/Designer's Address
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City
State �—_ Zip -
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ENGINEER'S NAME
Last �D First �� -Zz Lic. No.
Engineer's Address
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Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY /� -elei cey �` :, Lic No. � (�� Sty 1 Class
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Contractor's Address
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Contractor's il Address
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Stale rs�
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SETBACKS REAR (-
SETBACKS FRONT<_ PERMIT N�.�
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SETBACKS LEFT 3
SETBACKS RIGHT j PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $,�.
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