HomeMy WebLinkAboutX2019-3429 - Permit ApplicationPant Farm I Worksheet for Combo Building & Solar Permit Application R.-N-WA
F= Comm'I r Residential City of Newport Beach - Building Division 2Ql`� L42
NOTE: PLAN CHECK FFFS N IF aTTinnc nc ci ionnirrAJ
wilding FGrading F -Drainage lec (-Meth lum Cu Yd at[— Cu Yd Fill F_
Project Address (Not mailing address) r__Flood r Fire [- Liq [ Landslide rN/A Floor Suite No
Description of Work
, Use F_' Const Type
# Stories C # Units (if Res)
New/Add SF 1 Remodel SF Valuation $ e� �� y,
.Garage/New/Add �—} Material/Laboi fi'l�,) L\
OWNER'S NAME Last ye�JCt First JZ� — -- --
Owner's Address
Owner's E-mail Address
City
Zip ` n� Telephone—
APPLICANT'S NAME Lastj
First
Applicant's Address
A plicant's E-mail Addy s
CityState Zip — —Q elephone __ I
ARCHITECT/DESIGNER'S NAME LastJ
— ---- — First F_ Lic: No.
Architect(Designer's Address Architect(Designer's E-mail Address
City i — State Zip 17777 Telephone(
ENGINEER'S NAME Last F_ _ _First_---, Lic. No.F—
Engineer's Address Engineer's E-mail Address
City �- State F Zip l Telephoner—
CONTRACTOR'S
elephoneCONTRACTOR'S NAME/COMPANYr�! , Lic No:37 3ss 177
-- - - -
Contractor's Address Contractor's E-mail Address
4� - --
-- -
City �— State ZiP.. �� '✓ Telephone M�c��. j
SETBACKS REAR SETBACKS FRONT PERMIT N0. .�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. d1, 1 a
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $