HomeMy WebLinkAboutX2019-2458 - Permit ApplicationWorksheet for Combo Building & Solar permit Application
f COlnm1 j Residential City of Newport Beach - Building Division Woo
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G�
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[—Building F- Grading `Drainage f`Elec
Mech Plum Cu Yd cute
ct Address (Jot mali
Projeng address) Flood ( Fire cuvdFin
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j 1iq j` Landslide f'N/A Floor
`�Suite No
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Description Of Work
Use I ConstType
41
rr YPes�
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# Stories; tt Units (if Res)Fi
235 a?6 2 �r
New/Add SFs�� �
Remodel SFs�Garage/New/Add F�" Valuation $
Material/Labor 09lr.
OWNER'S NAME f""-'----------��
- Last I
Owner's Address �..%.� J��r^� l L -L First
Owner's E-mail Address
city
- /d -,r{" .i ere State Zip �'� ..-.
7I , r� Telephoner
APPLICANT'S NAME
Last���` �Gx4,SSd GI
Applicant's Address First _V'r '
Applicant's E-mail Address
City-- �--��— CJ C)r✓Js .J!G:..c.,.�.
State I �% Zi
ARCHITECT/DESIGNER'S NAME p 1yJ7� Telephone l�fi.�=,�ciic�s�,_•�9c�
Last—�—
Arch itect/Designer'sAddress First s--
Lic. No. r--�_--
Architect/Designer's E-mail Address
City
State �� Zip
Telephone—_
ENGINEER'S NAME
Last ��
Engineer's Address First G?� � Lic No. s•._ ,.j^7��.
7y`l
Engineer's E-mail Address
h�•.
City
,� j e:�. - State Zip
- `."_ �,J'I ,�iFj'� Telephone �i/Y)9'�
CONTRACTOR'S NAME/COMPANY
I L�: of 17'. z c ... w Lic.No.
Contractor's Address Sne,; _ jI / ([> Class
Contractor's E-mail Address
city
State 6�__ Tel
Zip rt r --------- t -e>> z..
-. I JJ��s� ephone) r ,.
SETBACKS. REAR SETBACKS FRONT
SETBACKS LEFT -- —__ PERMIT NO.
SETBACKS RIGHT
USE ZONE PLAN CHECK N0.
DEVELOPMENT NO
PLAN CHECK FEES $ 'i