HomeMy WebLinkAboutX2019-2457 - Permit ApplicationWorksheet for Combo Building & Solar permit Application
F Comm'] j 'Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F- Grading I—Drainage F Elec (-Meth Plwn Cu Yd Cutl �! Cu Yd Fill �
Project Address (Not mailing address) F Flood (-- Fire (- Liq F- Landslide �N/A Floor Suite No
�� C)
F
Description of Work
Use I Const Type
/ / l
2e , >-k7 (gL ( riz z (� z a�
/?r z i` A
# StoriesF�8 Units. (if Res)'..
-
L-2, 22 -Zgy-7 - 2Y3
valuation $
�--
�`.
New/Add SFF Remodel SF��' Garage/New/Add -
Material/Labor FifSk
OWNER'S NAME Last First
Owner's Address,{/
E-mail Address
IrOwwnner's
City / D State �� �:
/ V L,,, f�jl,,�4 I �'/ry'._ -
zip[q rJ Telephoner _
APPLICANT'S NAME- LastGx
First
Applicant's Address -
Applicant's E-mail Address
City ! �� 4 J. _ State 17
Zip `' Tele hone �,) ? q 6(y.- l y%`r
ARCHITECT/DESIGNER'S NAME Last
First Lic.No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephonel
ENGINEER'S NAME Last
First G7� �., i- Lit No. r'• _
Engineer's Address
—
Engineer's E-mail Address
:ej,10 7
City /F State L7
Zip (}2&,, � Telephone
CONTRACTOR'S NAME/COMPANY Lic. No.c c/ Class
f!++<� 3' S�?✓2�i�liHc...a�'. (_.�-+�.:.2y �r .: / 6 / U-r'�S 11S
O
Contractor's Address
Contractor's/E-mail Address -
�%C�tJ '�'^«�5,,+��., c--�✓Jif.
t.l..Y�� fFII.i JS �:!�.C�i�J_�l�L.,�
City �.j7�� ��� State���.
ISe.-..( t �7 _- ✓ �•. <,�r�-. •. I _/��Bd7�(�15k�
G.��>r.
Zip
C, c •�: Telephonelc 1 t i r., - L r `
l l d IL'4%�.
SETBACKS REAR SETBACKS FRONT
PERMIT NO. rjl-
SETBACKS.LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $