HomeMy WebLinkAboutX2019-2450 - Permit ApplicationWorksheet for Combo Buildin
mm'I ("Residential City of Newport Beach- Building D vission & Solar IYllt Application HEWao�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
U Y
rBuildi g F Grading �`Draina e
9 F_ Elec j` Mech Imo' Plum
Project Address (Not Mailing address) I` Flood ( Fire cevdcu d cuvdFill
Liq 16 Landslide'N/A Floor
- -- Suite No
Description of Work ``
Use l ConstType r
7 _ # Storiesj''�''
_ R Units (if Res)'. _
New/Add SFr_
Remodel ,SFr��' Garage/New/Add I Valuation
OWNER'S NAME K $ '
Material/LaborF.�
/.
Last ,.��
Owner's Address �� e—( `r`. e First
— Owner's E-mail - ss
mai�ad`dre
City State F Zip -------
APPLICANT'S NAME Telephone
Last dd ll/
Applicant's
F✓��t4SS�.< First
Applicant's E-mail Address
city `k r� c�
.� (!'s-eLN .. State
Zip r Telephone l/
�J
i � J
ARCHITECT/DESIGNER'S NAME �`
Last �_�—�_
First
Architect/Designer's Addre
sa Lie. No.
Architect/Designer's E-mail Address
City I
State_ ��—�
� Zip l Telephone
r---�W..._.� i
ENGINEER'S NAME -----
Last ���
First G7��i�
Engineer's Address �. Lic. No.
J'7c!L! t Engineer's E-mail Address
Cit — I
y State_. Zi
le
, Te
p l�;« % phonev,/Y),)�)i-
CONTRACTOR'S NAME/COMPANY
� e Gc� _ Lic No. cj Class
Contractor's Address jr"''"�` _�-�'ir�.,:
Contractor's E-mail Address
Cit
�'vf..„Gi✓ L.�✓.... CW .r �.. State %
Telephone
Zip
� (l`i`d l t) 4i•t' ,-di�`rf ;+3
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO.
USE ZONE
�_ SETBACKS RIGHT
PLAN CHECK N0.
DEVELOPMENT NO
PLAN CHECK FEES $ '
!I