HomeMy WebLinkAboutPV2019-145 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 6�EW pR�
City of Newport Beach - Building Division
F_ Comm'I f9 Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAI c,'�'-.>
Building Grading I—Drainage rElec rMech rPlum Cu Yd Cut 77Cu Yd Filll
Project Address (Not mailing address) Flood f— Fire j'-, Liq I— Landslide FN/A Floor Suite No
Description of Work
Use F— Const Type F
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# Stories #Units (if Res),
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Lwty E (SL4 iS-o rNUfee ce _ NO
Valuation $
Material/Labor] a0
New/Add SF 3$1a Remodel SF
Garage/New/Add F____��;
OWNER'S NAME Last
LE _Phtsl�c.
_ First
Owner's Address.
Owner's E-mail Address
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City _ILpaKK� Q� -._ -
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APPLICANT'S NAMEp� '
Last _CK
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First ��Jf/VW
Applicant's Address
Applicant's E-mail Address
c7547 AIONeex MvD.
City State -��
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Zip �';(w Telephone 70
ARCHITECT/DESIGNER'S NAME Last F—
First ��',��
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City - - State F_
Zip F_ Telephonel�.
ENGINEER'S NAME Last ��
First Lic No.F—
Engineer's Address
Engineer's E-mail Address
City State ��
Zip �� Telephonel�
CONTRACTORS NAME/COMPANY V I VINT SOt atrQV6 (OWL` (Q C Lic: No. er Classb c'qG
Contractor's Address
Contractor's E-mail Address
48+7 Ptanlp£K wvo.
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City &irvm SE `(�pi?iru s- State eA
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Zip 4?6(.7a Telephone 5`� 4rF2�2Z®
SETBACKS REAR SETBACKS FRONT
PERMIT NO 'e-i'v `tt
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK N0.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $