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HomeMy WebLinkAboutX2019-0562 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q FComm" '^Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F__ CuYdFill F_ �KBuilding 7Grading rXDrainage KElec F_Mech (KPlum CuYdCut Project Address (Not mailing address) F Flood F_ Fire F Liq r Landslide F_N/A Floor uite No y /%ari b pf�. N�GJF��T �t:� 44 Description of Work Use ConstType 1/' y �T i L/ ��1G �' �%� r �� V� r"c'S rf� /� �Jn/v��.�J �SI # Stories[— # Units (if Res)F! Valuation /t Material/Labor � U New/Add SFF-- Remodel SF 2�? � Garage/New/Add � OWNER'S NAME Last M1G�AFirst, 0 r �� ` Owner's Address Owner's E-mail Address t r-66 /vivilaT CeTtA PAlyeF C/yli�larc�@%rvi�eCGm�ny�� City A/ �G er �i�di �J State Zip �—' Telephone 9 em / APPLICANT'S NAME Last II, First A. _ 6 Applicant's Address Applicant's E-mail Address Cfizare5 @9rxsltte�sd Cdv�t City �,. 1 �Inr/_ �j State Zip (j2CV ✓t2, Telephone �jI(�o3Z�j, jgg3 t ARCHITECT/DESIGNER'S NAME Last lG� First !a f� //� Lic No. ¢ rvB Architect/Designer's Address Architect/Designer's E-mail Address -7, SrAw-sTP-e�, IF-i3 cow City Fot�4fj 1 i1 r o State G� ; Zip 92103 Telephone &/9. 325. I q90 ENGINEER'S NAME Last First F Lic. No.F Engineer's Address Engineer's E-mail Address City State Zip �— Telephoner CONTRACTOR'S NAME/COMPANY C L/ C,S �„ CD/%SGC L�(•� J Lic. No. 7� Ely G��, Class F c Contractor's Address Contractor's E-mail Address �I�ISf1 iFii�oi{ Ccc:'y ��. I�7G(! crflli fcE'�C(tJ CO,GGm City C()SM 42<s�v State ('A Zip 9Z&2 Telephone 7/L/—S ;�_5e7% SETBACKS REAR SETBACKS FRONT PERMIT NO.kv �� Z SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE �(,i—S' DEVELOPMENT NO PLAN CHECK FEES $