HomeMy WebLinkAboutX2019-0551 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
ON,
Building F_Grading j -Drainage j-Elec rMech F -Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire f- Liq F- Landslide [N/A Floor Suite No
F
__. _$ (SANutlo,
Description of Work
Use F—ConstType F
#Stories #Units (if Rest
Qt GV_ =
1 - OW =_ft 7
Valuation$ FQ,
Material/Labor1 OO
New/AddSF� RemodelSF�Garage/New/Add—
OWNER'S NAME Last
N WP 00 % ��� SI First
Owner's Address
Owner's E-mail Address -
101 roj CLr-_P lb
! i
City NZ
-: State I (4} Zip! �QS Telephone i $ I
APPLICANTS NAME Last
S M r. 1.1 First A SGV S
Applicant's Address
Applicants E-mail Address
11.71 WL C -A ov4 v
_i JL
City S.A 11RUPT 11161. /� , NA .......
State I Zip ._ LI1 1i Os Telephone -) 1 191
ARCHITECT/DESIGNER-'FS NAME
Last FirstF Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
City r
State F__ Zip F— Telephoned
ENGINEER'S NAME Last
X I AV First (D I A N d. Lic. No. S'�_ gq
Engineer's Address
Engineer's E-mail Address
1 S'io QtLOO IL14Ot.Low j4 4$"
City FSia A uA
state F 2;j- zip 91.105-- Telephone X14 662-OS`l0
CONTRACTOR'S NAME/COMPANY
(� V 6,us S M .T 14 Gtr At ST Lic. No. 63 � Class
1r
Contractor's Address
Contractors E-mail Address
41 CAAA10 w I I;CL
City F$!N0VTA , RVQ
State �— Zipq� Telephonel % I4 ZA I ICY I
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. X201q-m'
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $