HomeMy WebLinkAboutX2019-1119 - Permit Application1__ Print Form a Worksheet for Combo Building & Solar Permit Application
r Comm'I i- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFS ni IF AT TRAW nG ci ianniTTAi
[Building r- Grading r—Drainage r Elec (—Mech F' plum Cu Yd Cut Cu Yd Fill F_
Project Address (Not mailing address) F Flood r Fire F7 Liq r Landslide F_N/A Floor Suite No
Description of Work
Use ConstType
# Stories # Units (if Resf
Valuation $
Material/Labor
New/Add SF�— Remodel SF�— Garage/New/Add �—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State I Zip Telephone —
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
---- - -
City State Zip F— Telephones--
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip — TelephoneF—
ENGINEER'S NAME Last First & , 46 Lic No.F—
- -
Engineer's Address Engineer's E-mail Address
City State �® Zip �— Telephone ' J �Z 'ZLj j 2� �`,
CONTRACTOR'S NAME/COMPANY C /Lic No. �— Class
l 71 i�
Contractor's Address Contractor's E-mail Address
City L F7Z-/iY / 44Z-State L--?q Zip 77Telephone /
' 7
SETBACKS REAR SETBACKS FRONT PERMIT N0. mdaZQr-1 S
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ?q
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $