HomeMy WebLinkAboutX2019-1038 - Permit Application (3)Print Form Works eet for Combo Building & Solar Permit Application
rl Comm'I j R Residential / . ' City of Newport Beach - Building Division
l NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[—,Building [—jGrading F-;Drainage [—IElec ❑Mech []Plum CuYdCutF7 CuYdFill
Project Address (Not mailing address) ❑ Flood ❑ Fire [J Liq ❑ Landslide ❑N/A
lz�� ,Z3114 � Gy .
Description of Work
New/Add SF Remodel SF�0t'a Garage/New/Add f 1
Floor Suite No
F_7
Use ;; Const TypeF�7L? I
# StoriesFL I # Units (if Res)n
Valuation $ ll
Material/Labor
OWNER'S NAME Last Y�7J�� � First .S'TEP,, A/
Owner's Address Owner's E-mail Address,,
4,i`t e-Al C o 1--7
City �{16�_ jVeZ1>fie7 State �Zip Telephone Z ?t -$- G/
APPLICANT'S NAME ,t
Last / /7L-(4,%(G- --- - —� First .-• 5 � 6:--V-,4W
Applicant's Address Applicant's E-mail Address
(2_
',/7 GLUE �c.117 _Gam— 6(H-` t DIC OF ye4tt� C 0r7
City �Ek/i�xPTGC",p/ State �� Zip y2�;Go Telephone
ARCHITECT/DESIGNER'S NAME Last
P�k�rQ�� First %-,ej� Lic. No. C-7-Y(
Architect/Designer's Address Architect/Designer's E-mail Address
City C/�� _ State l �l Zip 6"73 Telephone 1 _ � 3Z0
ENGINEER'S NAME Last S� bL_t�� First Lic. No.
Engineer's Address Engineer's E-mail Address
City K � � G State Zip ` 2770 t Telephone 7(4-53T 2, 3
CONTRACTOR'S NAME/COMPANY Lic. No. Classn
Contractor's Address Contractor's E-mail Address
I
City State' Zip-�� Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. C-
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. j .
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $