HomeMy WebLinkAboutX2019-0566 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application oHE��gm
F- Comm'I Fes, Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL _05i
!Building [ Grading
F -Drainage CKElec r Mech PZ Plum Cu Yd cut F Cu Yd Fill F
Project Address (Not
mailing address) F_ Flood F-1FireLiq F7 Landslide F_N/A Floor Suite No
S�7 o Ll
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Description of Work
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Use I Y Const Type
# Storiess #Units (if Res)
r
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New/Add SF
Remodel SF F Garage/New/Add —',
Valuation $
Material/Labor5 ooj oo J
OWNER'S NAMELast First TVe_ W0.t�irnA ak tt, lit �GI'o/ �•. P.
Owner's Address
Owner's E-mail Address
100 IJe-wlpork ai..-_4•e✓
OCIQQp r 5u1{c loo rP bt vPA hAwl vSa. Cowl
City f I7ECr6�
State Ci> Zip %Z(oL6 Telephone R9k.7(oo•kl5a
APPLICANT'S NAME
Last N V First bp,
Applicant's Address
Applicant's E-mail Add ss
18vo4 Sk�P�k �-t��� r sU��e 2-0i)joey � sw�i5- arch
City 1 tl / 1
State (_AQ Zip (o( Telephone9qy• 157 240
ARCHITECT/DESIGNER'S NAME Last Syyl� First J SeQh `i
o Lic. No. C 2 -99
ArchitecUDesiignees Address
ArchitecttDesigner's E-mail Address
1r8t7bq ,-k� PGxl- GIrC l2 S,;1'Et s0Z> 4� SWL5-0.rC_VN. Cori
City �V 1HR
State Zip Telephoneqyp. jS7 �Zc�
ENGINEER'S NAME
Last 1Gt l,9 First E�j?ct� Lic. No.43 `ID
Engineer's Address
Engineer's E-mail Address
3`i5(. Gold1e--r`
�nQt�� Wo.� SkJn�e.�`1 Q Sk%eh9�s, coln7
City Lorbq LIwLc�I
State Zip c12'3B6 Telephone 7l.).fj72-ol"IZ
CONTRACTOR'S NAME/COMPANYIdS wrp Lie. No. Z jq S-�,I,,q Class
Contractor's Address
Contractor's E-mail Address
7v�W � ISL,:rt
,
,J/va SalarlLa �Cc,�+to-r� bui �c��•• -C��
City g %l3
State I 6 Zip � 7 Telephone t yt,Z
'i�1 L'„ 6c
SETBACKS REAR
SETBACKS FRONT PERMIT NO. Ll
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. L) Z
USE ZONE
112�
DEVELOPMENT NO 0971 PLAN CHECK FEES $ 1 U Z