HomeMy WebLinkAboutX2019-0911 - Permit ApplicationPrint Form / Worksheet for
„Comm'I F_ Residential X'19- 0 OTE:
Combo Building & Solar Permit Application ggjo City of Newport Beach - Building Division f� (�
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
;7\Bui4ding ' Grading r`Drainage 7,Elec PGMech Plum Cu YdCut F_ Cu Yd Fill
Project A dress address) (— Flood r Fire F_ Liq r f Landslide N/A Floor Suite No
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Description of Work
Use F—Const Type F_
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# Stories # Units (if Res)[_
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Valuation I
Material/Labor bor l
New/Add SF� Remodel SF r �� Garage/New/Add
OWNER'S NAME Last First Grj"_��c�%
Owner's Address Owner's E-mail Address
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City State I (rcTr Zip '�� Telephoned
APPLICANT'S NAME Last' 9v1�— First AU
Applicant's Address Applicant's E-mail Address
city /gp,�X/ State Zip j�J Telephone �/7�ZJ4,
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ARCHITECT/DESIGNER'S NAME Last 1 "�� First'
�./ Lic. No. r
Architect/Designer's Address Architect/Designer's E-mail Address
city State G _ State Zip/� Telephone
ENGINEER'S NAME �/,G� 5 �i7'�"—
Last G < Lic. No.
First
i
Engineer's Address Engineer's E-mail Address
City k� State WY Zip Wi;p Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. �— Class F
Contractor's Address Contractor's E-mail Address
City State �— Zip F Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 4f t:,L LZ
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 2--c'1'60 �}