HomeMy WebLinkAboutX2019-3841 - Permit ApplicationPrint Form Wor eet for Combo Building & Solar Permit Application o EWa°R.
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Comm'l .�sidential City of Newport Beach - Building Division X Ze(q _ 5 t4 [
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) r, Flood
r Fi e �i, L' r Landslide rN/A Floor ` Suite No
732 OA `rvo /JOAP 3-Zr�/_ 07 r.
Description of Work
Use Const Type V
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-0112 GBLV_A - AZQ7 41 4-
# StoriCl / Units (if Res)
aluation $
a,terial/Labor y
Remodel SFF—' Garage/New/Add
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OWNER'S NAME Last 009-E
First
Owner's Address -
Owner's E-mail Address -
337 VJA 400 SOUP
City- ZJFb2j- �j�Gtl State _Cs
ZIP c%Z.�6cJ - Telephone _'l iy 2Z� - 9 Zq
APPLICANT'S NAME Last�/,�j
First SF>:U�
Applicant's Address
Applicant's E-mail Address
2'732 2 , rST }�w�
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City cO%ZOpH xj y State �� f Zip /262Telephone j#f, 7/e-,3528
ARCHITECT/DESIGNER'S NAME Last (:R_/w`J.. i First G'yill M1A Lic. No. �. �2_�:, q
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Architect/Designer's Address
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Architect/Designer's E-mail Address
2732 E. G IsT >iw1 _
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City I [-E7kOk,�OQ%bZ 17A2-- State- Zip Telephone
ENGINEER'S NAME Last �pf - — f! j2�
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First Z�ib Lic.,o.r��
Engineer's Address
Engineer's E-mail Address i
0,-510SZ CAtfl C> C^P76-TA-ALx7 'ti 20l
ST�ve �SF� �tJ�/uer�or rs °Cqy�
City L� �°r61�lUF AJ)6L7�1 State C Zip
&'t2 Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. 6Class
Contractor's Address
Contractor's E-mail Address
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City �— State F_ Zip
F_ TelephoneF—
SETBACKS REAR SETBACKS FRONT
PERMIT NO. (,2.G'16(
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO �(,
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PLAN CHECK FEES $ `