HomeMy WebLinkAboutX2019-3097 - Permit ApplicationPrint Form
f�Comm'I (- Residential
heet for Combo Buildir-w 9 & Solar Permit Application
City of Newport Beate-_�i - Building Division Z®l Q
NOTE: PLAN CHECK FEES E-_tJE AT TIME OF SUBMITT L
Building r Gradinginac
Project Address (Not mailin
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of Work
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address) Flood j' Fire F_ Liq r Landslide ) /A Floor Suite No
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Use vpke Const Type
# Storfsl / # Units (if Res)F
Valuation` j
New/Add SFF— Remodel SF �5 ',_. Garage=res ew/Add �— Material/Labor
OWNER'S NAME Last "�'� )j✓ly��j� C.S/ . First
Owner's Address Owr,,ear's E-mail Address
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APPLICANT'S NAME Last �'�l"� First) 1 11,4zK
Applicant's Address
Applicant's E-mail Address
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city
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State
Zip
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ARCHITECT/DESIGNER'S NAME GI��:� f First f`U
Last 7 � � � Lic. No.
Architect/Designer's Address
Arorlitect/Designer's E-mail Address
State
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Zip�
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City
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ENGINEER'S NAME Last I First I Lic. N
Engineer's Address - __ _ Engineer's E-mail Address
City ,. State Zip Telephone
CONTRACTOR'S NAME/COMPANY ")-zj F1'id AIA/*�S Lic N° • �10'�DIQ Class "Irk
Contractor's Address
City`SF'-VtIV State L', N
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
ZipL7"ZL'(rf Telephone �, L, (I - (:'4-C, G, U ,�0
PERMIT NO. L�(
PLAN CHECK N0. DA
PLAN CHECK FEE2 n