HomeMy WebLinkAboutX2019-2751 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application�fi"°° m
City of Newport Beach - Building Division o
Comm'I i i Residential xZolq
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ❑. tea"
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Project;Address (Not mailing address) C Flood n Fire �j Liq F-LandsliderN/A Floor Suite No
Description of Work Usen Const
Type I
3 13 to Thi Yao m 1� yh o 1
# Stories #Units (if Res)
Valuation $
New/Add SF Remodel SFi Garage/New/Add-� Material/Labor
OWNER'S -NAME Last _' qy��{� =J First ; /2 (��%
Owner's Address Owner's E-mail Address:.
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City it/ , o . T3 ' J State L Zip l J Telephoned T
APPLICANT'S NAME Last.,Gz vl J firstl :gyp 12'
Applicant's Address Applicant's E-mail Address
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City /v`//i%�O/ State �! Zip' p23 1 1 Telephone ' I���/S
ARCHITECT/DESIGNER'S NAME Last First Lic. No.—
ArchitecNDesigners Address ArchitecUDesignees E-mail Address
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City State F IZip Telephone 1
ENGINEER'S NAME Last — J First Lic No.F
Engineer's Address Engineers E-mail Address
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City State F ZipF_ Telephone
CONTRACTOR'S NAME/COMPANY )`L�/Y} I (2,0 pS 1 YV Lic. No. 1�z7is_Oi Class j3 a
Contractors Address Contractors E-mail Address
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City LAA`�w v State F ZipF7 Telephohe /V
SETBACKS,REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $