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HomeMy WebLinkAboutX2019-0069 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application qraiv 4Comm Residential City of Newport Beach - Building Division /t Z� )� �0(0� NOTE: PLAN CHECK FEES *D/UE AT TIME OF SUBMITTALoa� Building Grading Drainage Elec r Mech Flt Plum Cu yd cut._ Cu yd Fill Project Address (Not mailing address) (-i Flood I' Fire r— Liq r Landslide [_N/A Floor Suite No IMpNT(�AL &11- NC-Wfo+tir-&pea 4/,l0 F Description of Work kcpLtrC_ Opp(-& rtr4-s wirypc—X - pew vlrr-t6Es rtwa D&fi-Ines itj S1hwmS NE -w 6we,&Tr - //or AU •Tr CC- Ftar�T New/Add SF Remodel Garage/New/Add OWNER'S NAME Last Avog P4 /S -TE -A b'/L&rsj Owner's Address Owner's E-mail Address City State Zip APPLICANT'S NAME Last I n4 /j -/S TZ7L Applicant's Address �a ala -LE -21 � cityw-* P P yL r State C Use F_ Const Type. # Storiese # Units (if Res)r ht6ee First . M Ii'N q Applicant's E-mail Address amahj 1'efet-(� a° 1, Ce tM Zip Telephone y! d b T, gx/Cff ARCHITECT/DESIGNER'S NAME Last 41V iYLLI First ��-- %LJ �lif1-y Lic. No. Architect/Designer's Address S ra nl6 'bC—Cl/!<6 /A/C Architect/Designer's E-mail Address R/J f 9_ C—ve- b snug (MCS @ STVMe FVKei0C L"W City I FV VIOU State I / Zip0-Telephone ENGINEER'S NAME Last f First F�,_, Lic. No.rFv...- Engineer's Address City State r� Engineer's E-mail Address Zip Telephone CONTRACTOR'S NAME/COMPANY I Lic. No. F; Class F_ Contractor's Address City ^..,..�_-. State SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT Contractor's E-mail Address Zip TelephoneF�— PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $