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HomeMy WebLinkAboutX2019-0053 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application PoRB Comm1 r Residential City of Newport Beach - Building Division c"roP NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL t -Building ( -Grading rDrainage rElec r: Mech F -Plum Cu Yd cut Cu Yd Fin Project Address (Not mailing address) r! Flood r Fire r Liq r Landslide rN/A Floor Suite No F_ 9m� 4✓©c,+D0 A✓&. 1 Description of Work ODI C t LE (7 - i LL q tAj Alto Use Const Type # Stories # Units (if Res)F `' F3lct�MERCuRy `r �tS �� F�T•� Valuation $ i Material/Labor New/Add SF1 Remodel SFF— Garage/New/Add F__; OWNER'S NAME Cp%1\N\ERc,IAt- L3K1 ERS 1lyL, cc 6-1--) Owner's Address Owner's E-mail Address 53!02. UoLSA- � GI�GIE Su/TE G City StateC3fE• ZiP 94 Telephon ..._l.. T,-75TS APPLICANT'S NAME -if✓ 1 �-. Applicant's Address Applicant's E-mail Address 731 Nopl i _9.4 -irk s;T.- JA -146 (0�J P'�7-,4oK4 City 6--,,\tq& State Zip �6 Telephone ./ i/3t�0 ARCHITECT/DESIGNER'S NAME/j� Lic. p�fp�p s3 f+ lel+ No. 7 Architect/Designer's Address Architect/Designer's E-mail Address City State r Zip F—, Telephone—! PROP t i (71A�1�56�`S Nt9iv1�.' The FV I N F-� COM, ,�; _ CONTACT /{fl%ZON FR, �� s f�7i19 Kit ICU 19 1110 IlIJNo VATl6N City (��(/�� State �; Zip g2,/Bt� �, Telephone ?44 ZO/ ?- O CONTRACTOR'S NAME/COMPANY rRu�MA Lic No.Z66S3 Class: Contractor's Address Contractor's E-mail Address 73t _ N&4h _ Wig q 9T--cyA tires iJ -is c. wl city1 StateFPZip Q2, Talephnna SETBACKS REARI SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. D4�1 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $