HomeMy WebLinkAboutX2019-1303 - Permit Applicationvvortcsneet for Combo Building & Solar F ermit App licatioi n F� Po r
I` Comm'I v " � o m
( Residential City of Newport Beach - Building Division r t
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building ( Grading FDraina e
g � Elec j` Mech � plum Cu Yd cut
Cu Yd Fill
Project Address (Not mailing address) I- Flood C Fire Liq r Landslide j—N/A Floor
Suite No
Description of Work
LSC"v7Gf�[ Use ConstType
�(C'iCH�i
AA> # Storiesr� # Units (if Res)
VE 11
New/Add SFF — Remodel SF I — -- Valuation $
L95 Garage/New/Add Material/Laborft
OWNER'S NAME Last p
First
at'�C i�l
Owner's Address -
r— Owner's E-mail Address
city C 7Aa a
State�j�—
' Ej]; Zlp 3, Telephone , `{q e 2C�®� pia ry�
APPLICANT'S NAME Last a c
First
,Applicant'sAddress F G7
Applicant's E-mail Address
City
PUi_ State ZIP Telephone ?._.; 7. 50-tv
ARCHITECT/DESIGNER'S NAME [
r Last �� First'
ArchltectlDeslgner'sAddress - � Lic , No. t Architect/Designer's E-mail Address
Ot— d
city . 1 �ti �et+ "9' 14A %L:
t �� i [ State ZIP 126 t 3 Telephone ✓)
ENGINEER'S NAME ' L- t
Last First Lic. No.
Engineer's Address
Engineer's E-mail Address
PC=T
City State74
ZIPS Telephonef�
CONTRACTOR'S NAME/COMPANY
Lic No.� Class
Contractors Address
Contractor's E-mail Address
City State FZip Telephone[�
SETBACKS REAR SETBACKS FRONT��
PERMIT NO r i
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO PLAN CHECK NO. It
PLAN CHECK FEES $