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HomeMy WebLinkAboutX2019-3265 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application F Comm'I F Residential City of Newport Beach - Building Division ? 1 vi - C. 210 (i' NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM AL (;Building F-" Grading (-Drainage L Elec (% Mech plum =Cu Yd Cut l Cu Yd Fill Project Address (Not mailing address) F Flood r Fire r"Liq F Landslide f N/A Floor Suite No f�(V I Description of Work Use Const Type '412 W fC'5�601cF MOT ®'A, # Stories #Units (if Res) New/Add S e odel SFV— ew/A d `Garage/NJ�- Valuation $ -I. Material/Labor OWNER'S NAME Last ��. First � 2. Owner's Address 50 Owner's E -Mail Address J Z �4,�juC� �JC� Ccr�/1c!j f �LC IUjGc� C (2 Ce etvlvc(C/n .C:o� City JG,n raj c,; o State �.e, e--. Zip iFVi FL—, ! / (J Telephone. F AME Last SGMci-�' .First {�0/t Applicant's (Applicant's E-mail Address V/ti JO/t�SC{ .OG.n C f State- Zi ,� C G - P f �(y(`G O Telephone ''%?�?Sz? ARCHITECT/DESIGNER'S NAME Last ----- I C. First is �.. nl r! Lic. No. j � ^7 Architect/Designer's Address , ' � ] � / S Architect(Designer's E-mail Address i(�L [ r(t 5� U'A t� X24 �t� City �Z_1 C(�r�SC` StateFC � ZIP �fo v TelephonActl c 6-7 ENGINEER'S NAME Last V V it E y������'� WRC: t,�f('f���aEngineer'sAddress. 7}! -mailAddress(Dc Cj� CityState ( dl �, Fp. ZA` TelephoneCONTRACTOR'S NAME/COMPANY Sy `� e o C<C CLicssf hContractor'sAddress -J-mail AddressCity State F e��-, ��KP�G �(�ZipTelephone�G SETBACKS REAR SETBACKS FRONT SETBACKS LEFT t PERMIT NO. SETBACKS RIGHT . t z PLAN CHECK No, . ` IGS USE ZONE DEVELOPMENTNO (� `' PLAN CHECK FEES $