HomeMy WebLinkAboutX2019-1211 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ? a
IX Comm'I F_ Residential City of Newport Beach -Building Division �t1, lZtl
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RBuilding F_ Grading (`Drainage rl Elec RMech r Plum Cu yd Cut r Cu Yd Fill
Project Address (Not mailing address) f' Flood F_ Fire [- Liq F- Landslide F'N/A Floor Suite No
RO NEWNP-"i" CEIJTE-9 Awe
Description of Work
Use F' Const Type
# StoriesF # Units (if Res)
Ul l ER REQ( r> tE v -t Z
Valuation $
Material/Labor 61 DOS
New/Add SF� Remodel SFF—I,
Garage/New/Add F—
OWNER'S NAME Last �V(
First ®fe`"/
Owner's Address
Owner's E-mail Address
800 NFWAR-r CEMtER 0g4VE
AAA401.17A01A1a 66^e4t-Y-eon
City At WPO�T ISr�&CN State ein Zip �jZC4d Telephone�t(Q-(e7P--J434Yi
APPLICANT'S NAME Last TOS
First I C4fR LS
Applicant's Address
Applicant's E-mail Address
CKt)M wE t:L
C Td+Y s � EM Co r'z • �l=_-r'
City I (-VINE State RA
Zip[ q Z(rd 8 ' Telephone ggct 5-33-3-q S -k
ARCHITECT/DESIGNER'S NAME Last�(M u
4 t5^r
First ( ✓
r9 EN Lic.No. 35 3
Architect/Designer's Address
Architect/Designer's E-mail Address
4QAa(. ST. SutTig ZAPS
�iGE✓�- iAe�+Ouarr �' 6A441c. C4 /it
City AIGWOUR-r 615AC4 State 6 A
ZZip C Z6 G o Telephone iqq 73T -7-qo Lf
ENGINEER'S NAME Last i=R6E n
FirstR j0F_P—T Lic. No. /"ze �
Engineer's Address
Engineer's E-mail Address
? CQ-0MWELf_
K F14" 9- Elm tOV— AIFT
City tRVINE State �—
ZiP g7-6fg Telephone qyq Y60_0q
0
CONTRACTOR'SNAME/COMPANY FVtcox MESO
ENEf26tf SyS-r&"S' Lic.No. 6/t77r Class acro
Contractor's Address
Contractor's-E-mail-Addres
.2 Cieo"tW*-L
C rgys@ E�41ce>z.AIF— 7
City I I ✓Ida State
Zip Rru� p Telephone 94(q q66- C(46
O
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $