HomeMy WebLinkAboutX2019-3596 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Residential �a�WP°Rr
City of Newport Beach - Building Division�T,'
Comm'I}� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building j Grading (-`"Drainage F_ Elec rMech Plum CuvdCut e cuYdFill
Project Address (Not mailing address) F_ Flood F_ Fire [ Liq F Landslide (_N/A Floor Suite No
15/7
Description of Work
Use F Const Type F
6V &A
# Stories', # Units (if Res).
I(-N AT ldI V N8A/_Cczvy
Valuation $ %
Material/Labor
SF Remodel SF Garage/New/Add
New/Add (�
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OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City,. o ct J {,�� State C Zip 2- rF, 2 Telephone
APPLICANT'S NAME Last S'v1 (�! /fit V 1 First��
Applicant's Address Applicant's E-mail Address
City Co �t s//J State C Zip ZG2-7 Telephone (,?(o Y C �` 2�
ARCHITECT/DESIGNER'S NAME Last W First Lic. No.�
Architect/Designer's Address Architect/Designer's E-mail Address
City F State Zip ' Telephoned
ENGINEER'S NAME Last FC� F-(5 7-/ eq N5 c /1i First S v . f - Lic. No. k( c-- ,�i r/
Engineer's Address Engineer's E-mail Address
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City Zip 1 State 1 T d Telephone Z 1�
/(.�- C. G1
CONTRACTOR'S NAME/COMPANY / Lic. No. Class
j
Contractor's Address Contractor's E-mail Address
City F State Zip F� Telephone s
SETBACKS FRONT N0. (
SETBACKS REAR PERMIT .E1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
Or,