HomeMy WebLinkAboutX2019-0253 - Permit ApplicationY 210 101 _0MG 3
Worksheet for Combo Building & Solar Permit Application
r7 Residential City of Newport Beach - Building Division
NATE: FLAN CHECK FEES -DUE AT TIME OF SUBMITTAL
Iuilding r Grading rDrainag[EI ec�-1' Plum cuvdCut � cuvdFill �.
Project Address (Not mailing address) r Floo Fire ( Liq �j LandslideN/A Floor Suite No
Yol Nl&op - 1 --
Description of Work
New/Add SF Remodel SF j ,SC�J Garage/New/Add F_
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
Use Fm Const Type F/
# Stories[—)I # Units (if Re
Valuation $
Material/Labor¢106)
000
CI l IJ N{ Q ---------.. _ - -
- — _. Vic•_ �l�ctrr�a,�.SL�2.-.� __.
City � `� � State F6, __-ii Zip�L Telephoned
APPLICANT'S NAME Last
Applicant's Address
n i
1)S- V61V Z� %0
City ( , � State 1tik
First
Applicant's E-mail Address
Zip Telephone
NAME Last S �IG � First�WX6 Lic. No. CC��:
Architect/Designer's Address
City T State p�
Architect/Designer's E-mail Address
2ilrtkQ_
Zip -I-�b�io Telephone
ENGINEER'S NAME Last First Lic.
Engineer's Address
City ':`C�!.V__..._--.._-- State
Engineer's E-mail Address ���� d
Zip [i�i — Telephone
NAME/COMPANY Lic. N Class
Contractor's Address Contractor's E-mail Address
City State I Zip F __ — I Telephone-- —
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. A wll' V b
PLAN CHECK NO. DI NO.2oI1
PLAN CHECK FEES $ 1251 `53