HomeMy WebLinkAboutX2019-2446 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application �EWaa�
F 'Residential City of Newport Beach - Building Division '
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
I`Building F Grading F -Drainage F_ EleaG
Mech plum Cu rd cute Cu Yd Fill
Project Address (PJot mailing address) F Flood F Fire
Liq Landslide f Floor N/A
II Suite Nol
o i F - �r
Description of Work
Use I Const Type
�I�(Jr � /1
k Stories��, 3-13�J� #Units (if Res)
New/Add SFF — Remodel SF
Ma
Garage/New/Add ��; Valuation $
terial/Labor'�s'�
OWNER'S NAME
Last --r— &C First
Owner's Address
F-50 __ Owner's E-mail Address
City
�r
i /.`d .[•c.. 1j r..re-�-.0 State �� �--�.. -
Zip r%I ,60 Telephoner
APPLICANT'S NAME
Last �-)
A L/l�.c'-SS�� First r ;/—Ijs
pplicant'sAddress
Applicant's E-mail Address
City n �-
.,c .,, �.Lj, �J.,<.. State�A
r r Zip <Telephone �l)0; ,1c.��f<t,_ tt;$r9tj
ARCHITECT/DESIGNER'S NAME
Last—`�
Architect/Designer's Address
First Lic.No.
` Architect/Designer's E-mail Address
City.
State � Zip J Telephone[�
I
ENGINEER'S NAME
Last'
FirstLi
al ri��` c No. t"•,.,
Engineer's Address
/6/ /. Engineer's E-mail Address
City F
r(, j ¢�.. StateWV
Zip c�:2 Fiij'.� Telephone V7lY�9'•?
CONTRACTOR'S NAME/COMPANY
Lic.No.) `l(�lL, Class FL
c idl.w�/�'rL
Contractor's Address �� _Lnr�,:
..p Contractor's E-mail Address
City
• < 1/. ,�
,.,� �>.<y.t ... State A�
�._. 11 A _ _ ZIP f%7�x:� Telephone /,�— ,
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SETBACKS REAR SETBACKS FRONT �A
SETBACKS. LEFT PERMIT NO.,' 1 _
SETBACKS RIGHT
USE ZONE ----__ PLAN CHECK NO.
DEVELOPMENT NO '—'— --
_ � PLAN CHECK FEES $