HomeMy WebLinkAboutX2019-2001 - Permit Application'�G WpF��W�Rm
rin orm Worksheet for Combo Building &Solar Permit Application
Comrn'I rl Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
17 Building r Grading rlDrainage rElec r,Mech r Plum Cu Yd cut Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire r. Liq r Landslide rN/A Floor Suite No
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Description of Work
Use F Const Type F
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# Stories #Units (if Res)
tb 6L.NV QLN0
Valuation $
New/Add SF�—' Remodel SF L� n1 �j g Garage/New/Add �'
Material/Labor G�r7to Qo
OWNER'S NAME Last I L Pi 4, to First
Owner's Address 6LIA--[ �
iyN'i k�t�{�1%t7r7�1 OwriersIt-mail Address
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City_ — State C� Zip plS6l% Telephone
APPLICANT'S NAME Last First
Applicant's Address CA,-iGo GO N (Y2,ArTa5 L.1. C� Applicant's E-mail Address
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City (12�11Nvu State [Z" Zip 1/Jo� Telephone Li Llq'fa��-��J�IT
ARCHITECT/DESIGNER'S NAME Last FirstLic. No.
Architect/Designer'sAddress '-�D 011; opl, CA -N Arhiectesigner'sE-mail Address
City State F Zip Telephone
ENGINEER'S NAMELast First Lic. No.
F F
Engineer's Address Engineer's E-mail Address
City State F Zip �— Telephoned
CONTRACTOR'S NAME/COMPANY C/ ZD U ci Lic. No. `?q 070 Class CrG.
Contractor's Address kZj h- PL.I,C�Vi At,Nt%_/Contractor's E-mail Address
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City l (f % tN �i State G e Zip i�oi 4j Telephone &J t+ -15.6_O� _
SETBACKS REAR SETBACKS FRONT PERMIT NO. +
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.Q0 k%0 tel
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $