HomeMy WebLinkAboutX2018-2612 - Permit ApplicationPrint Form Worksheet for Combo Building &Solar Permit Application a"`W�"a
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City of Newport Beach - Building Division y- `'
NOTE: PLAN CHECK FEES DUE AT TIME OF SURMITTAI
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Project Address (Not mailing address) Fire Liq Landslide ❑I N/A Floor Suite No
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Description of Work
Use 771 Const Type F_
#Stories It Units (ifRes)n
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Material/Labor � C/
abor
New/Add SFF Remodel SF Garage/New/Add F �
OWNER'S NAME Last .—"5' �_ First I
Owner's Address Owner's E-mail Address
CityF-'nate Zip Telephone
APPLICANT'S NAME Last First
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Applicant's Adddremiss" Applicant's Address
.E-mail
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City �� (�m� ,(State d�� Zip 2 Telephone L
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ARCHITECT/DESIGNER'S NAME
Last First i Lic. No.
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Architect/Designer's Address r Architect/Designer's E-mail Address
City — _ J State F___� Zip __� Telephonel
ENGINEER'S NAME Last, First I _ tc. No._C-�
Engineer's Address Z}( LSu: S'iM10
Sfj'��—'j/�j�-��1 Engineer's E-mail Address
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City State Zip Telephone1�� ('
CONTRACTOR'S NAME/COMPANY Lic. No. I ClassF7
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Contractor's Address Contractor's E-mail Address
City State Zi Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.�J,f�t�-"Z-✓�I�j
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $