HomeMy WebLinkAboutX2019-4036 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application oq_,w,
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL JL
Building Grading
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Project Address (NoCajling address) [_ Flood F- Fire r Liq
Project Address (No Lands /A Floor Suite No
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Description of Work
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# Stories #Units (if Res)
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OWNER'S NAME Last
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Owner's Address
Owner's E-mail Addressf_,..
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State FT Zip 2 (pL5. TelephoneF----------7
APPLICANT'S NAME Last
5 V L C I "A N I First I � D i�
Applicant's Address
Applicants E-mail Address
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-> T/DESIGNER'5NAME
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Arehitect/Designer's Address
-flreditest/Designer's E-mail Address
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State �— Zip �) 2 Telephone `j (,j 27
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ENGINEER'S NAME Last
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Engineer's Address
Engineers E-mail Address
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CONTRACTOR'S NAME/COMPANY/
Lic. No. �— Class
Contractor's Address
// Contractor's E-mail Address
City
State F Zip I- Telephone[ —
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 1v�1� 4o
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. t o
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
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