HomeMy WebLinkAboutX2019-0573 - Permit ApplicationX/�-OkC�;( 057
Print Form j Worksheet for Combo Building & Solar Permit Application
-- - - City of Newport Beach - Building Division -
r Comm'I �/ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Floor SuiF_ Fte No
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Use PTVConst Type 5
# Storiesir # Units (if Res)'.
Valuations FV;;
Material/Labor
OWNER'S NAME Last �I First -Too
Owner's Address Owner's E-mail Address
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APPLICANTS NAME Last I N2wyew First -NSP,
Applicant's Address Applicant's E-mail Address
131511 oww0 CAPIgrep me STS • A
City I SAN �jPN (�AP(STLA-NO State I CA
ARCHITECTIDESIGNER'S NAME Last c9 �t-llCl�c
Architect/Designer'sAddress
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F5_156l 7 J4 00 0_APl8 "j,10
City [SpA J,p M CApSTeAW State F
ENGINEER'S NAME Last
Engineer's Address
180 S. 'FjZ0%ECT Avg . L91C-�V- 610
City ��.�)� State—'i
P,NNA .624
Zip I qz� Telephone 6yq) , X14(0 . gqq 1
First ( oFF Lic. No. F_',
Arch tect/Designer's E-mail Address
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Zip C;2EcJ Telephone Cgaq) yq(,,gggj
First FAc iV Lic. No.F*
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY A IG40tSONCoPPpM.IY Lic. No. q Class '
Contractor's Address
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City F1A_ZWftV-f 'eo& State
Contractor's E-mail Address
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Zip Ll� Q Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. X" D� l✓
SETBACKS LEFT SETBACKS RIGHT m y C PLAN CHECK NO. 041 A0
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $