HomeMy WebLinkAboutX2020-1149 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
Ej Comm Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL &A
_�Bulldlng r! Grading ?,6rainage/fiec —
Project
0, Cu Yd Fill
,p4ech r -orm Cu d Cut
Project Address (Not mailing address) f—j Flood Fire —',NIA
Liq [j Landslide r Floor Suite No
Cr f F7
Mo Allow
Description
of W,
Descri n F'ption Of Work 4 - va-l-A A I
Use FOR, Const Type
FW
# Stories # Units (if Res) i
T
---------------
New/Add SF
Repo el SF valuation
Gar /Ne d
It Material/Lab
al/Lab
OWNER'S NAME Last First -------- -------
Owners Address
T
1_2502 Owner's E-mail Address
City
State
_E7 ZIP ! Telephond — -----------
APPLICANT'S NAME Last
Applicant's Address ......
1041 W. 18th St, (A106)
City JFoViIa Mesa
State CA
ARCHITECT/DESIGNER'S NAME
First
Applicant's E-mail Address ------- -
Jason@dchartdesign, net
Zip 92627 Telephone jNP-T2T�l 91
Last Richert
. First Jason
Architect/Designer's Address
11041 W. 18th St (A106)
I W._18thSt,(A106)
City Costa Mesa State C
Lic. No.
Engineer's E-mail Address
Zip Telephone
07
Contractor's Address
City State
Ir
Lic. No. F�-
Architect/Designer's E-mail Address
Jason@richartdesign
Zip 92627 Telephone roll �111.7
ENGINEER'S NAME Last WANKETFirstriTE7L7
Engineers Address
R0R9)Z_0_eN_qd_a 7ee_yT_Cq,p_U
L--
City ITEMECULA,
State
CA
CONTRACTOR'S NAME/COMPANY
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
L 1 c. No. F __ 6qR1_(11 Class
__ __j
Contractor's E-mail Address
Zip
0 1' Telephone[ 11-7 `fit
.1 ---- i - - -------- - -- - - - -- 3
PERMIT NO, X3014 - 11
PLAN CHECK NO.
PLAN CHECK FEES $