HomeMy WebLinkAboutX2019-2459 - Permit ApplicationWorksheet for Combo Building & Solar permit Application P°�
Comm'I j 'Residential City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL z
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Project Address (Not plum Cu rd cut i �–
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Floor Suite No
Description of Work,
Use Const Type
f -4" z q _ /� # StoriesF k Units (if Res)
New/AddSFe—` 2/% 21 2 7
FRemodel SF
Garage/New/Adde�Valuation$ i
OWNER'S NAME Material/Labor *G}'{_
Last —r-- /, [L
Owner's Add ress�1��� �� �y Gr✓ LFirst] -
Owner's E-mail Address
City A / '7
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APPLICANT'S NAME Zip q_LZG, Telephone`
Applicant's Address Last First C
{Applican
4./f I's E-mail Address
city
State
Zip
ARCHITECT/DESIGNER'S NAME , Telephone l? -
- Last
Architect/Designer's Address - First
Lie. No.
Architect/Designer's E-mail Address
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City i
State e -
Zip
ENGINEER'S NAME I TelephoneF
Last. -� �__"�---
Engineer's Address First FZx, IJe,. Lic.No.S�n7�
(��, Engineer's E-mail Address
city
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State �` -
Zip Telephone�
CONTRACTOR'S NAME/COMPANY V7/Y), , :,,- 114
l 415
Contractor's` 1/� LIC. No, &I : Class��
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- Contractor's E-mail Address
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Telephone
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SETBACKS REAR 99.
FRONT ^/
S LEFT
SETBACK--�__ PERMIT NO.
SETBACKS RIGHT
USE ZONE PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $
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