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HomeMy WebLinkAboutX2019-0145 - Permit Applicationpn_ Worksheet for Combo Buildinnn Solar Permit Application sai �/ City of Newport Beac Building Division C Comm'I Y'� ResidentialNOTF, PLAN CHFRK FFFc IIF OT TIM1AF (1F CI IRM1AIITAI v Building ❑ Grading []Drainage :�Elec OMech ❑ Plum CuvdCut I CuvdFln F Project Address (Not mailing address)lood [Fire Liq [Landslide ❑N/A Floor Suite No jj 1 F-71 F777 Description ofWork Use Const Type lith q IVAI # StoriesC #Units (if Res)C 5 Material/Labor �. II�� New/Add SF � Remodel SFGarage/New/AddValuation y' �'J i � OWNER'S NAME LastFirst Owner's Address Owners E-mail Address p� n� Cih' M5 State zip Telephone APPLICANT'S NAME Last m % c-.eA?° First t J vy Applicant's Address Applicant's E-mail Address city p41i%11rZ State �� —i Zip .�>.J Telephone J °7%,z �7 ARCHITECT/DESIGNER'S NAME Last I First Lic:No. Architect/Designer's.Address Architect/Designer's E-mail Address i City State Zip Telephone 'ENGINEER'S NAME Last - j / First . 7; - ,w Lic. No. GK Y� 0 i�.! I J . Engineer's Address 'Engineers E-mail Address City I ISANI4 k�, State 44 Zip ✓ 0/_ Telephone CONTRACTOR'SNAME/COMPANY Lic.No. y -t t(7y Class Contractor's Address Contractor's E-mail Address City _ State �, Zip Telephoner SETBACKS REAR. SETBACKS FRONT. PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. (w fAll— .USE ZONE DEVELOPMENT NO PLAN. CHECK FEES $