HomeMy WebLinkAboutX2019-0437 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
iX Comm'I r Residential City of Newport Beach - Building Division O 3Z3-,2019
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALX,;Zo/q.0q37
JXBuilding r- Grading F -Drainage f-Elec R'Mech F- Plum cu vdcutF Cu Yd Fill
Project Address (Not mailing address) r! Flood F Fire r` Liq J- Landslide FIN/A Floor Suite No
Description of Work
Use F Const Type F
# Stories[ # Units (if Res)!!
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Valuation $
New/Add SF I— Remodel SF
Garage/New/Add
Material/Labor a Ot 000
OWNER'S NAME Last � )2/d (, {��v
First ,S A U L
Owner's Address
Owner's E-mail Address
MAC,4eT(4Ua CoueT
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City N u/POr T /36ACt( State Fc rt Zip gZ660 Telephone qyq-S-OZ-6/!,31
APPLICANT'S NAME Last T(..}YS
I First car -1S
Applicant's Address
Applicants E-mail Address
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City I P-t/t Vc State �A,
Zip F R 2100 Telephone qe4q
ARCHITECT/DESIGNER'S NAME Last UAN plssE L First KEN vETI� Lic. No. a r R q 9
Architect/Designees Address
Architect/Designees E-mail Address
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City State Fo4
Zip , Telephone 71q-YZ0_Ze?e00
ENGINEER'S NAME Last LM �CAl4T
FirstGCFNN Lic. No. a3g
Engineer's Address
Engineer's E-mail Address.
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City n FvJf612T trellco State Ft -'a'
Zip g�66v I Telephone qql 02(4(- 6'/i4(
CONTRACTOR'S NAME/COMPANY E/ACo P- A41FS4
&NCQG Y Lic. No. (ou& — '', Class ,
Contractor's Address
Contractor's E-mail Address
a CAMU16LC.
I CTi4YSe FMcoi2./"67
City I P-ViNIF State CA
Zip Telephone 0qq-4160 Oci6U
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X D If l — CHS7
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO. OS 2-:21 - ZO l
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ ®b • 3D