HomeMy WebLinkAboutX2019-0158 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
i Comm'I j Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building i Grading F-Drainage r Elec FMech
r" Plum CuvdCut r— CuvdFiII r
Address (Not mailing address) r Flood (- Fire j_ Liq i" Landslide I N/A Floor Suite No
Project
I J-36 V I A L 11--:) Q tqa F—p> AS6RNJ'o(2-T I Cor�, F~ F _
Description of Work
Use ( Const Type ri
# Stories? # Units (if Res)7
�—
5q)
f::- J .
Valuation $ (� G�
d!i
Material/Labor)
New/Add SF �— Remodel SF Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City r-s®--s-- State �-
Zip ! Telephoner
APPI !CANT'S NAME Last 1 T�o/�_—
First
Applicant' Address R�Sao/�t1�
PP
Applicant's E-mail Address
/cFd ( 9 c, ,9 7- 5� / o
f, C� /V E-i
City t�l-f f, 76(Z-T %ti- E_4- -q State (rC %-i
Zip Telephone 7_/ 7 c`� �/ Z 5�
ARCHITECT/DESIGNER'S NAME Last I "C'- %
First Lic. No.
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City I g& State � ^
Zip Y2,��d Telephone f,, j
ENGINEER'S/NAME r—, I Z
Last' S i� / �
First P qsd N _ Lic. No.r--
/
G` J�S ('� �"���
Engineer's Address
Engineer's E-mail Address
6-
9 7 a Y N �F' plz c _
cityV -✓ i 1 �6 oAJ XA7WT( State �-t / e
Zip I q Telephoner ('V y7( - 67,72
CONTRACTOR'S NAME/COMPANY Lic. No. �1 Class g
C'c�t�STEZC _, L�
Contractor's Address
Contractor's E-mail Address
_
�C1�f Fi�tiLlJ�z\ ��
aK*4Sca__ PMlz-C,0.isTfoe-aC)
City SArJ T,4, ALVA State Fe
Zip F9 2705 Telephone) -711 7 27Z
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X�� I ^ i✓,��
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. kkk
�l
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
I I017