HomeMy WebLinkAboutX2019-2930 - Permit Application (2)(�519Af ��ktWt7-) X20 r,C1-2130
Prjnt Form Worksheet for Combo Building & Solar Permit Application ���"°
F- Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G<�.o.�°
rBuilding r Grading Drainage (—Elec F Mech F Plum cuvdCut cnYdFW
Project Address (Not mailing address) r— Flood r-- Fire r Liq r Landslide f 'N/A Floor Suite No
Description of Work FJN G Ct ) . LE Q( — I'LLIA hA;h
Use F_ Const Type F
Ch r� aa(, E c2 St�n� . R60.41;iq :
#Units (if Res)
r IStories
�,a RAS CARE �, I � s 3 iy AlN l3 Eei�g
Valuation$ Obi'
Material/Labor;
��T Jo5.6PA ilk
El�SZ79�(,E�l W G deE G (;�'.'"g�
`('1"rA'w
OWNER'SNAME—% C.oMP/4t4
Owner's Address
hso _ p
City .fTC'Lv Q L c-44, State _...Cr'' Zip 9�0�?O_ Telephone
APPLICANT'S NAME:D,/}VC- eRAu ,CO,e'�%
/
Applicant's Address Applicant's E-mail Address
7 3/ 1460 Mkli l 5� Gl�r ✓� @ J83D. �o�y
City Q�i"'n �q'� State C f} Zip Telephon / r4i[)Z 931- 821?3
ARCHITECT/DESIGNER'S NAME �NiLl� sjw( LicNo
Last �Y $ �. First. .
12
Architect/Designer's Address -7R(,tevi w (L 1i,1 G Architect/Designer's E-mail Address -
City �— _ �' State F -77-i Zip F_Telephoned—'
ENGINEER'S NAME i I/ Last FirstI Lic. No.
IV
Engineer's Address Engineer's E-mail Address
e
City State I Zip F Telephone
F
CONTRACTOR'S NAME/COMPANY.Rue44, r jT' (1t4c CdAf) da Z' Z> c. No. J16653 class 42-:
Contractor's Address Contractor's E-mail Address
73/ c�M/6� 11�33p . C'ms�
City State Zip Telephone
(�2gsvg� � gzs'6� (7i4) z3i—V-9,:?
SETBACKS REAR SETBACKS FRONT PERMIT N0.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
�-�-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $