HomeMy WebLinkAboutX2019-3201 - Permit Applicationk 24t11 - 3241
Worksheet for Combo Building & Solar Permit Application
❑ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
,_Building E] Grading ❑Drainage ❑Elec ❑Meth [7 Plum Cu rd Cut Cu Yd Filler
Address
❑ Flood E] Fire f7Liq [7 Landslide
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Description of Work
-EXT _O�JO ()ej to 14 p ci 1714- i'e7 C X (C T /f^y 4? -6,,e sv69/9 _i
New/AddSFRemodel SF Garage/New/Add �,,
OWNER'SNAME Last C _ _ - , First %pl F, A
Owner's Address
1(000) Ice ,-; GN
City I /UPI -3 I State
APPLICANT'S NAME Last
Applicant's Address
City State
Owner's E-mail Address
Zip
First
❑N/A Floor Suite No
Use F71 Const Type
# StoriesC # Units (if Res)
Applicant's E-mail Address
Zip Telephoned
ARCHITECT/DESIGNER'S NAME Last I First Lic. No.
Architect/Designer's Address
City State
Architect/Designer's E-mail Address
l
Zip Telephoned
ENGINEER'S NAME Last e� First N L j Lic. No.�l
Engineer's Address
i
City State
Engineer's E-mail Address
Zip F_____7 Telephonel
CONTRACTOR'S NAME/COMPANYLic. No. � Class W7E_
�'.WAVG N AA,4—tr-CJ,
Contractor's Address
� (0R N ew i u.—W ✓bM
City � State R ,
Contractor's E-mail Address
Zip�a7 Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. iir IIj -?77 0 f
SETBACKS LEFT L—s' SETBACKS RIGHT PLAN CHECK NO. t ^
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