HomeMy WebLinkAboutX2019-2454 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application �EWP°�
F_ Comml j Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL „.•�
F_Building F_ Grading F Drainage f—Elec (`Meth
F - Plum Cu Yd Cut cuydFiu F
Project Address (Not mailing address) [ Flood r' Fire F- Liq Landslide 17N/A Floor Suite No
Description of Work
Use ConstType
24
#Stories. #Units (if Res)'
Valuation $
Material/Labor 7k.
New/Add SF� Remodel SF�— Garage/New/Add
OWNER'S NAME Last 11`ar l
J First
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Owner's Address
Owner's E-mail Address
City ,.� �,?r�� _ State �-
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Zip
NAME ,Last ��� rSfd
First
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Applicant's Address -.
Applicant's E-mail Address
4`:'..Gn
City / State 7
Cit ��"
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PlTelehone `ll 7.3�? P �6)t' J
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ARCHITECT/DESIGNER'S NAME - Last l First Lic. No,
Architset/Designer's Address -
Architect/Designer's E-mail Address
City. State �-
Zip I _ Telephone® J
ENGINEER'S NAME. Last �'
First 7r Lic. No. s'_; r;n70,5
-
Engineer's Address
Engineer's E-mail Address
17VY' 1,.4 .4 111 /Iv2 , a!/O
City �r State /z
Zip ! :� Telephone 7/y) ✓�'
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CONTRACTOR'S NAME/COMPANY j : -
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i Lic No.. r,
rr Gam.j ;Ie_, / l��ilG Class
Contractor's Address
Contractor's E-mail Address
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City '�'lo�.2c-'^`i? State (�
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Zip �if ✓:.i'_y'.:, Telephone C<q f' () ilat+ - W l)
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. -X2U�6(
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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