Loading...
HomeMy WebLinkAboutX2019-0249 - Permit Application�TD4�;l5 C .Y 1 (_15,1 g 4 t'Ex M I T_ X ?A (I . l ?1 qq PdntForm Worksheet for Combo Building & Solar Permit Application as PoRa r Comm'[ r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rlBuilding F. Grading r`Drainage Elec rMech F_Plum cuydcutF Cu ydrnlF Project Address (Not mailing address) r Flood r Fire F Liq r Landslide rN/A Floor Suite No ft 4 0d A.:D o u� Description of Work Use F—Const Type F � # Stor[esF$ # Units (if Res)F1ASTnL�ori fl&�u�hf/A7-76tj ZValuationFy� e�,6 q �© Material/Labor Q� OWNER'S NAME I r V{ j4aQW /;! A4 N, Owner's Address r Owner's E-mail Address 116 INcLadRTtao.6 4VS ga•,�oN fiJey city 1-k 1% I G state FCA, Zip 9 Telephone g4/% %"Zfi -2 APPLICANT'S NAME DAVE ER B � %bR -fRt fC9 ✓FK $ L) Applicant's Address Applicant's E-mail Address .731 _N®� w�a-inc fit` el/�i/��jrJI33D. �� City I F Zip Telephone I`�(`(l ogWcrE State ARCHITECT/DESIGNER'S NAME I iKLk6_tjgk �/ R (o Last � i'� � First Lic. No. 2 653. ArchitecUDesigner's Address Architect/Designer's E-mail Address city F— - State �—i: Zip F—! Telephone—' ENGINEER'S NAME N ^' Last First I Lic. No.F_ Engineer's Address fT Engineer's E-mail Address City State F Zip r— Telephoned CONTRACTOR'S NAME/COMPANY-Waal"AV Jq( S3� Lic. No. 2�5—j class }3/CSI Contractor's Address Contractor's E-mail Address 73/A-( 6577 City �� State ��— - Zip rz Sri Telephone 'd��F �iTj(.- Q Z-13 SETBACKS REAR SETBACKS FRONT PERMIT NO, 2c> 1 q• ozq,!j SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 4C> `i'2�1� USE ZONE DEVELOPMENT NO PLAN CHECK FEES $