Loading...
HomeMy WebLinkAboutX2019-1816 - Permit Application (4)Print Forn:A Worksheet for Combo Building & Solar Permit Application �rEW�am X Comm'I F_ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �.�.aa+" [-Building r- Grading r -Drainage I-Elec F Mech j-" Plum Cu Yd Cut Cu Yd Fill � v Project Address (Not mailing address) r Flood F- Fire f` Liq F_ Landslide FN/A Floor Suite No l 3 o Oe_ 0 ( N`L-UJ �PCIC`C i' 202 n�_ (fl a 6a5 �— �_ ..-- Description of Work Use � ConstTypeF_ # Stories # Units (if Res) _._. Valuations Material/Labor lJ�+ New/Add d SF � �.Remodel SF Garage/New/AddI OWNER'S NAME Last First I T_4'ut0 C_ Com pG.YLIJ Owner's Address Owner's E-mail Address 115-7bazjGAP 6 vc _ C�Slrr V5 Q Qcesa-�SLepS , (Z-Orr) City ..Q_`O�v &IN 1N State cA Zip '7 to Telephone 94_', 70q`_ 0M APPLICANT'S NAME Last First T'iga y Applicant's Addrr�ess,/� Applicant's E-mail Address �+ y� (�lC�^�-t �J �c,UCJ, �--t.,moi Ii�1 City 'COt911 tri ub_!L(C, �1 7 State CAZip _ '1 O��r� Telephone [/Z(-615-- 11'7 ARCHITECT/DESIGNER'S NAME Last First—, Lic. No. �- Architect/Designer's Address Architect/Designer's E-mail Address City � State F_ Zip F-_-- Telephoned—'. ENGINEER'S NAME Last First f '' Lit. No.F_ Engineer's Address Engineers E-mail Address City State �-, ZIP I _..._.-_,-.— Telephoner---_.-...--.-_.... fLO CONTRACTOR'S NAME/COMPANY PeCU� m f1 9( Ck C� Lic. No. 713 x($"12 Class �J Contractor's Address Contractor's E-mail Address 1p©f6oK 5 52.1 ,ujQE e6fe5fvm OLOr26 -COW) pTMC/ City g J o nA-f n C \O VV -\'W r, State �C,As --...- Zip I `A � 0,S Telephone 7114 • �j I J_- (o II`1 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ x00 1 K�N U