HomeMy WebLinkAboutX2018-2009 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application \
F Comm'I Residential City of Newport Beach - Building Division ou)
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) i Flood F]Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
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Description of Work
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Use FI Const Type I
Of,
# Stories # Units (if Res)
Sly 00c% t
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New/Add S F Remodel SF 7v13 - Garage/New/Add F
Valuation $
Material/Labor V rr 00
''OWNER'S NAME Last ST(L1t AA/�-_IE i First �N
Owner's Address
Owner's E-mail Address
Sd 6 U r'LC N 1 A/ J
City [/1 State
Zip Telephone qqGj-(2`d'. �QCI
APPLICANT'S NAME Last I
First
Applicant's Address Applicant's E-mail Address
City State Zip F Telephone
ARCHITECT/DESIGNER'S NAME Last First' J Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State [- J Zip F-----] Telephoned
ENGINEER'S NAME Last Po w � J First d [ � X7'/ Lic. No. �' 37�� ._
Engineer's Address Engineer's E-mail Address
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' -ONTRACTOR'S NAME/COMPANY fl Lic. No. F__77 Class
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tractor's Address
Contractor's E-mail Address
State J Zip Telephoned
ICKS REAR SETBACKS FRONT PERMIT NO. C.o I
CKS LEFT SETBACKS RIGHT PLAN CHECK NO. 157L4 - ZZ/
NE DEVELOPMENT NO PLAN CHECK FEES $C� ..