HomeMy WebLinkAboutX2019-1017 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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Comm'I /Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F-Drainage lec F_ Mech
rkum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f Flood F- Fire F_ Liq �,andslide FN/A Floor Suite No
I S65 PeI�T iRL- &AR i PL
F_
Description of Work
Use Const Type
1�1'Z-��� AD7ifror.� � <<„�i+��; 2�tr�„D�•i
# Stories? # Units (if Res)[_
Valuation $
Material/Labor
New/Add SF ic-I z RemodelSFI i ev Garage/New/Add F_
OWNER'S NAME Last SHV r=Ser=
First LAJftA
Owner's Address
Owner's E-mail Address
i 6 i,S Qc, X�i 'ShCaC�l�2�i '�(..
City I 1.v,"p,w:� State GA
Zip cAZ6&C) Telephone'Igc I) 633-0`I5c
APPLICANT'S NAME Last jAAtIt
First Gi�AN�
Applicant's Address
E-mail Address
255Et ApV_lN,3 , Sr-.CHAKEruiiiraCa�
jjApplicant's
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City viG-SQ State FC
Zip `l Ijl Telephon cicfei)-447-
ARCHITECT/DESIGNER'S NAME Last :S prt ��i First j}Et 6-;1 S Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
1-�S6y Volta -F EE=tom GtRc_6
City State GA
Zip c125c,'3 Telephone Cci 065s'g_yyZi
ENGINEER'S NAME Last ki±;ZG
First I rvN Lic No.
Engineer's Address
Engineer's E-mail Address
Cc,-ZN',lAii+S
City Igwitj� State
Zip CI%Lc, Telephone I lg(fh)SS1
CONTRACTOR'S NAME/COMPANY t�yc JS i2d.0 i tOt� !QC_ Lic No. 834.84`i Class
Contractor's Address
Contractor's E-mail Address
ZSSE.i I�OKIAt_:�a 5 i ,
LNr1hN[ c� E�Cc Ji /��ti�� ICN. US
City {vttSS, ory V 1 c-- j C. State C'
Zip Tin49 ( Telephone lcld�,'}�Z `iCi 6 t
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ,i�7�� �� — I Ci �7
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.�jl
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $