HomeMy WebLinkAboutX2019-0822 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q
City of Newport Beach - Building Division
Comm'1 Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F Grading rDrainage F- Elec F Mech F- Plum Cu vd cut Cu Yd Fill
Project Address (Not mailing address) F- Flood F- Fire Liq r Landslide F-N/A Floor Suite No
2121 MIR.AMAF- M •
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Description of Work
Use Raj ConstType v�
# Storjes12#units (if Res)
( AQDN • OV E
1Z,E A&6t7FU, K IT•
Valuation $
Material/Labor 7sldt'=
New/Add SF I C7./J Remodel SF 'J�
Garage/New/Add
OWNER'SNAME Last l..R.wIrNI6►1
rrt'y� I`/
First CHgje-7'(NE
Owner's Address
Owner's E-mail Address
2t2 t MI RaM>a•R t
l45AVQ60W a) -(a('iCO. COM
city N WPoRr BSA • State Ft� 9 (,o I a4q - 5cn - 0120
Zip _ 1 Telephone
APPLICANT'S NAME Last FOF-RST' L
First CyjplG�.
Applicant's Address
Applicant's E-mail Address
8 KANE
IJoN�oN�►pr-oa✓ r� to l�• COA
City L'�� f State db
Zip 3 Telephone
ARCHITECT/DESIGNER'S NAME
JONSSONANbF�ER•STitL Last�Q�L
First C�RIS Lic.No.�
Architect/Designers Address
Architect/Designer's E-mail Address -
G•I-1..rt AMMW— t o N I r c
JoN%M AND�-
city sw r+l C.µ im State F—
zip 3 Telephone Kf�- 228 - 49�16)
ENGINEER'S NAME Al•0'R+ Last JowhoN
Lic. No
First t)�— 't.r L igl`('-
Engineer's Address
Engineer's E-mail Address
99ta G41Li. A.Ma•NWM uN (r c
VON ONA�lm D�GIM�IIL•GdM
City SW CLJ�l ' G State I CA
Zip 9 IS Telephoneq *aio
CONTRACTOR'S NAME/COMPANY f
T- $, I�7 fNy f _ Lic. No. ��� Class C(�
l
Contractors Address V
Contractors E-mail Address
IFMI morC S
-61A 1i0 cn C QGv1m cmc- cuol
City ��T �� State-
Zip �l�) Telephone �. ���7����
�Ol
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. U
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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