HomeMy WebLinkAboutX2019-4052 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit Application (Aaw
r' Comm'I y( Residential City of Newport Beach - Building Division X261q - 140 5,2' \ NOTE: PLAN CHECK FEES ni IF AT TInnF nF cri ianniTAi
Building r' Grading
[-Drainage r' Elec (- Mech [- Plum Cu Yd cut Cu Yd Fill F7>Project
Address (Not mailing address) r Flood [- Fire [- Liq r Landslide rN/A Floor Suite No
ems" � oN I �_
Description of Work
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UseF?-,TConstType
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CoL(t'stil N TEAK LOuA—�o.J
# Stories' # Units (if Res)F
Valuation
, ;oNew/AddSF��
Material/LaborKJ
TL
NEW"��IZ.S �
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Remodel SF�— Garage/New/Add
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OWNER'S NAME
Last . zz' VIN (""T
First
Owner's Address
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Owner's E-mail Address VFAZ21 S(Z @ 6,vo, t �• �Nrl
23 W, OC
-VAN Pf2o^i V @ L T
City (j
State ZipC?9 /o G I Telephone 81 gT437- 27 8
APPLICANT'S NAME
Last �jn �S �.Ie a+( %�F First
`vv ` ` \� 1
Applicant's Address
Applicant's E-mail Address
City I
State F_ Zip F Telephone—
ARCHITECT/DESIGNER'S NAME Last II^^ First � Z Z,5
�l— I-""i�'1� Lic. No. 0
Architect/Designer's Address
Architect/Designer's E-mail Address
"( WCl,(
FF— T(L F2afJlz@.IW*QtZ04I-CECTuc2E.Cowt
City fjp
State Zip R26�p Telephone � (42-52 12--
ZENGINEER'S
ENGINEER'SNAME
Last First '��S.iL (� Lic. No.Fc s43+
Engineer's Address
Engineer's E-mail Address
180 . (G�- ST. � 8 fiAtZlkn.7 � �S�-Fh1 r_ ,cows
City
State 15 Zip R 2 7 0 j Telephone (T 14):? 35- 2800
CONTRACTOR'S NAME/COMPANY 1 nLic. No. 74gg g Ll ClassFR
Contractor's Address
Contractor's E-mail Address
City I 'j>`sttPIIL Lc ;,{.
State I "' Zip 11 7t D Telephone 626-1,72^7069
SETBACKS REAR
SETBACKS FRONT PERMIT NO. x7/�♦G �� ` ��
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO' '2•'1-iCS
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $