HomeMy WebLinkAboutX2021-1326 - Permit Application___Print Form _ Worksheet for Combo Building & Solar Permit Application 0-7;,�,�Comm'I rYftesidentialCity of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL617
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Description of Work
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Valuation
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New/Add SF Remodel SF Garage/New/Add ��—
OWNER'S NAME Last First ��Yir y
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Owner's Address Owner's E-mail Address -
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APPLICA(N_T'S NAME Last Ule_illsf First
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last s�/.G /r�Gd I jNrA/!
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Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First F Lic. Nof—
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Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address ��Coritractorsal ddress
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City �� State F_ Zip F_ Telephone
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SETBACKS REAR SETBACKS FRONT PERMIT NO. X
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SETBACKS LEFT SETBACKS RIGHT 3 PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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