HomeMy WebLinkAboutX2019-1169 - Permit Application (2)Print Form <_J W,orksheet for Combo Building & Solar Permit Application
Comm'I r Reside Ai I City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading rDrainage [_Elec rMech F_Plum CuvdCut F_ cuvdFill
Project Address (Not mailing address) 1- Flood F_ Fire [— Liq - Landslide I—N/A Floor Suite No
5�oo Tovcrz, NF(JJpo•Q-( � 1Soo
Description of Work
Use Const TypeI A
0141-16 13oy MrooLmold or CNiin-E WIT6E, NOP-LaAD
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#Stories �O #Units (if Res)
FQ(L71_ hpS po
(i IZ5 � QOWt:2 cLe, � Llc U76NC7
FLS vw Fk;NIl�Inl
Valuation $
Material/Labor / Z/ 6v"
New/Add SF� Remodel SF X11
Garage/New/Add
OWNER'S NAME Last 12 L)Ce-
First Promq CUoa•ly.i {(FjyJcuC/G)
Owner's Address
Owner's E-mail Address
Soo 3iR�N s7. 5-w7,�7 /20
13/onNt_mucc reµ y - no/E2� 5 ue � � �'ugNcocic. corp
City N�Wpo2V /,�6gcu State cls
Zip �j2G�0 Telephone g99-�SS-9361
APPLICANT'S NAME Last QafVEQ o
First /11g2K
Applicant's Address
Applicant's E-mail Address
VOA/ kA011,4" li✓c. S0/7C 200
/r/•�u2VP�/o J`i/1%P/'i o�-a l'ci7%�Pc'tf• coM
City f 2vi = State 719
Zip g2`Iq TelephoneF�"--yoo-9/31
ARCHITECT/DESIGNER'S NAME Last let fL�1 First LI $p Lic. No. 3 SZ$
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Architect/Designer's Address
Architect/Designer's E-mail Address
VON1&*Q12MA1J '9vC• rut -re- 20*
G•ke(�&Pin�c�;orcCc�lfec�S.c�/
City /iWNC State C�
Zip �ul� TelephoneF
ENGINEER'S NAME N//Q Last
First 7 Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State �
Zip F Telephone�—
CONTRACTOR'S NAME/COMPANY ugh
Lic. No. by 5f7 (o Class
Contractor's Address
Contractor's E-mail Address J(�Jo 1)
319V 6-4
i fire eJLC Asso
City l �5 /�z 5 State
Zip qZ� Z 6 Telephone7(`-T2 r - 4t'
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK F�$
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