HomeMy WebLinkAboutX2019-0626 - Permit ApplicationPrint F6rm Worksheet for Combo Building & Solar Permit Application oF�EwPoae
Comm'] F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT T
IME OF SUBMITTAL -
F-Building ❑Grading ❑Drainage ❑Elec ❑Mech ❑plum cuvdCut
F7 CuvdFill
Project Address (Not mailing address) ❑ Flood ❑ Fire F7 Liq r Landslide ❑N/A�Floor — Suite No
Description of Work
�FIQ c n , t7 Use F7 ConstType F
`1 �x��to'r /oo(i L1 W1 Gu4rd �«t'1S
# Stories[' # Units (if Res)F—
New/Add SF Remodel SF Valuation $
—_I �� Garage/New/Add—'. Material/Labor
EOWNER'SNAME 1'Afl,Last T � 1�fL(''Q✓L`1 LFirst
—.__ _ddress -_----'Owner's E-mail Address
k� P cat ; 2LS S L-'C d� State ' ZIP � Telephoner —
APPLICANT'S NAME Last F
/� �1 1� � I � �-t j ✓'l i�irst
Applicant's Address Applicant's E-mail Address
---,State
S_ Sp1/�Zct ctL�—_A,CO�
City �Q s CSC. tate
-li i �i� Zip'
�Telephone 94�.3,3y
ARCHITECT/DESIGNER'S NAME 1
Last �--I First �^ Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City State �� Zip � Telephone�—
ENGINEER'S NAME Last FO D NN (, L -, First F� �/ I N Lic. No. S
Engineer's Address Engineer's E-mail Address
115D S.0LIVE ST. S>01T>= �6DU o ll -- — J — _ co tovte@ ,5 k c.o m,
City LDS �/Irrsr���r State I - -�71- -----— ----
-5.—. - -- GA Ji Zip 00 j � Telephone o 1 _2 _ c�-% 1 _2000
CONTRACTOR'S NAME/COMPANY c No.
_RUSSeI1�QDih-�ica�hYftcoi� �Zrj2LliClass�3i 4
Contractor's Address Contractor's E-mail Address
E! e MCon}rbtt,n
— - -- ----
City �241----_-
diQ5 State �� Zip `] $ S I Telephone '� t
SETBACKS REAR SETBACKS FRONT PERMIT NO. r ��
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N LA
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $