HomeMy WebLinkAboutX2019-2938 - Permit Applicationo1a6d -,208
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Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
I -Building F_Grading rDrainage F_Elec F-Mech F- Plum Jydffl SP.Q1, VISION
Flood r Fire Li Landslide ?POI Q BEAOHite No
Project Address (Not mailing address') C q " S
Description of ork 'P v jc L i �J �I Use Const Type
\A Sa Q5 Cru ,\ C o.1S4
K J'U
` \ #Stories #Units (if Res)
L0 G� W ASL w +A �(
Valuation$ i y 5 h
New/Add SF Remodel SF Garage/New/Add Material/Labor1
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OWNER'S NAME Last \ First
Owners Address Owners E-mail 'Address
'523o 2 4
City _. State C ZiP p\. —ri\ Telephone 5i�CI _%0A y2 Z. -
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City _. �-.MzS� State I `_" Zip _g262. -t. _ Telephone 4CZ<. g -I\\.
ARCHITECT/DESIGNER'S NAME Last First SZuC_.r% Lic.No.�a
Architect/Designe
es Address J ArchitecUDesigners E-mail Address
City_C Or /o�e. State _ �..�- Zip :i2_- .t- Telephone. Z \L\' ES-W2e6,
ENGINEER'S NAME Last qq�First g plc, c r , Lic. NoT
Engineer's Address `n J Engineers E-mail Address
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City i�fa✓�gL.. __... _ State ��c.. ZIP �ZY,b(,Telephone ly)Sr,` ,\L\Zia,
CONTRACTOR'S NAME/COMPANY r C Lic. No. Class II IS
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Contractors Address Contractor's E-mail Address
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City d1a\�oa.,"�. _ . State �'; zip _�ZSO� Telephoner y4'i-5y4
SETBACKS REAR SETBACKS FRONT PERMIT N0,MW10— Wf! V �
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. i• i
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $