HomeMy WebLinkAboutX2019-3618 - Permit Application�s
Print Form Worksheet for Combo Building & Solar Permit Application
F- Comn- 1 F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
("Building F_ Grading F -Drainage f`; Elec F_,Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) E Flood
F_ Fire r7. Liq F- Landslide F_N/A Floor SNo
�
l-
Vf /YNVGvFO2r._/ a�� t lI�LIFt-.
Description of Work
Use F— Const Type F_
12>�,d.moi ? r s Z�� GU
7-64 7-iY--=- 5/a crr
# StoriesF # Units (if Res)F
Valuation 3,
New/Add SF[— Remodel SF
Garage/New/Add
$ C -e
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State Zip I Telephone
APPLICANT'S NAME�. —
LaSt 7,ciE✓i�'iv�3- �G+�...
_. First
Applicant's Address
Applicant's E-mail Address
�..
di 2dale i r Fe t.. i- C ✓L.a G q v GsL i c c�s�` P,. tid c
City a4z2_C4?Jr4 State ��.
Zip ;t9aG TelephoneGzz. °asp Zy/
ARCHITECT/DESIGNER'S NAME Last
First � Lic No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F _ _ State _.
Zip ��, TelephoneF�
ENGINEER'S NAME Last
First j' Lic. No. 7
Engineer's Address �,:„
Engineer's E-mail Address
fZ.a3ee 42G: 41 /3d -W_- a
city j, ,aver __. - _ _ State FzW_.
Zip �� �'. Telephone qvp
CONTRACTOR'S NAME/COMPANY , i T y1c c,r`2rS 1 �C Lic No. 7 �r 3 L� Class
Contractor's Address
Contractor's E-mail Address
/42/n'5"s-y 4-10,
City .�;2�y,1StateW
Zip `/'ibvfn Telephone G>2G>.`,�;77ov5-7
SETBACKS REAR SETBACKS FRONT
PERMIT N0.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO/ L Vit:
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ -