HomeMy WebLinkAboutX2019-2439 - Permit ApplicationF- Comm'I
Worksheet for Combo Building & Solar permit Application G.RResidential City of Newport Beach -Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building F- Grading F -Drainage F_Elec F_MachPlum curdCut ) I cuvdFill
Project Address (Not mailing address) F7 Flood F` Fire F- Licl r Landslide 'N/A Floor Suite No
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Description of Work
UseConst Type F
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# Stories #Units (if Res)71
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New/Add SF��. Remodel SF�. Garage/New/Add ',�
Valuation $
Material/Labor *,>
OWNER'S NAME Last �"/J _ zZ(J First _.
Owner's Address.
Owner's E-mail Address
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.CityLr jGxc..Q State
Zipv Telephone��..
APPLICANT'S NAME' -Last
First
Applicant's Address -
Applicant's E-mail Address
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City State
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Zip/ Telephone (�}ir`;, t L(,e - `IVY)
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ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
ArchiterUDesigner's E-mail Address
City State F_
Zip TelephoneF_ v',
ENGINEER'S NAME. Last �-- First 7 Lic. No. r•.. n
Engineer's Address
Engineer's E-mail Address
1Ie0
rV7/0City State
CONTRACTOR'SNAME/COMPANY �� pf r Lic.No. G�,�l���� Classy
Contractor's Address
Contractor's E-mail Address
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City�I, ,�r�� Stated
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Zip tl"i.`a� Telephone[(e
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SETBACKS REAR SETBACKS FRONT
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PERMIT NO. )�%_C) 1 —'7,42 1
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. -
USE ZONE DEVELOPMENT. No
PLAN CHECK FEES $ -