HomeMy WebLinkAboutX2019-0550 - Permit ApplicationV
10
Worksheet for Combo Building & Solar Permit Application
r Comm'I I- Residential City of Newport Beach - Building Division
•� nu,v 0=CC n11C, AT TIME nl= Cl IRMITTAI
F -Building r- Grading F -Drainage Vr Elec' rMech r Plum Cu Yd CutF Cu Yd Fill F
Project Address (Not mailing address) C Flood F- Fire C Liq F- Landslide CN/A Floor Suite No
SETBACKS LEFT
Description of Work
Use F Const Type
# Stories # Units (if Res)
DEVELOPMENT NO
Valuation $
Material/Labor
New/Add SFF— Remodel SF�— Garage/New/Add F
OWNER'SNAME Last Na wPomz G(L ST First-
- Owner's Address Owners E-mail Address
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City _. _ State �,- ZIP q 663 Telephone I4 q
APPLICANT'S NAME Last M i W First
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Applicants Address Applicant's E-mail Address
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City � 1K N� State �/ /� Zip 1�Z'�. (��Telephone %/I 4 g I q%
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �—
Architect/Designers Address Architect/Designers E-mail Address
City �— State F- Zip F— Telephone—
ENGINEER'S NAME Last 1 AO First FQ f Al C: Lic. No. n- $ q
Engineers Address Engineers E-mail Address
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City WTA AKA State -GA— Zip ��.^) OS Telephone X14 66.7. Oslo
CONTRACTOR'S NAME/COMPANY INCl/✓ C,^ITW COWC.Lic.No. 617440 Classl Q
Contractors Address Contractors E-mail Address
1'�3 4-L (�AOV1'0 tl
City S (�� �j/(V State �NT Zip q�% pS Telephonel?I4 S (� 9
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SETBACKS REAR
SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
PERMIT NO. X(1A("( 0 () y7V
PLAN CHECK NO. C)"o-WIq
PLAN CHECK FEES $