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HomeMy WebLinkAboutX2019-1450 - Permit Application (2)qut A- kqg Print Form Worksheet for Combo Building & Solar Permit Application QComm'I residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r wilding rGrading F -Drainage [_Elec [_Mech F- Plum Cu Yd Cut F_Cu Yd Fill Project Address (Not mailing address) r- Flood r Fire r- Liq r" Landslide FN/A Floor Suite No 3 Description of Work Use WH Const Type IN 2N.4L �/t'IOD� L. # Stories # Units (if Res)" Valuation $ Material/Labor p New/Add SF�.-v' Remodel SF I�7 -, Garage/New/Add OWNER'S NAME Lastl First�1�y *J tl, I \ Owner's Address Owner's E-mail Address }�ttly mlina yo ,-Q�..pyr.a-G_b City StateG�Zip1o0�w PE "f2_ _Telephone.g'1q3�? APPLICANT'S NAME Last � uLt/�� First � op"'gI Applicant's Address Applicant's E-mail Address �` 2 �VL-DJS E P2 -C t. P6N oc. City rl.J_ �,k_ S rjro State Cr_..� I�— Zip Telephone "719 ,`I- a.1__ ,UiiC ARCHITECT/DESIGNER'S NAME Last First F— Lic. No. F_ Architect/Designer's Address ArchitectlDesigner's E-mail Address City— State [-- Zip(--.-.-TelephoneF_ ENGINEER'S NAME LastLi First YV`�`� c No.�a3Z� Engineer's Address Engineer's E-mail Address 3©O 2", Z 7/e 4, sr c 7elle_& City State I Z�F ZiP (�(pZi. Telephone �¢��2¢..�23 / CONTRACTOR'S NAME/COMPANY WRA_ NNN C nU L_DI�� ��5'GN Lic. No. �C-q076 I Class W Contractor's Address Contractor's E-mail Address ld�a VLocSC PC r� a%o-cL>7J✓it City} -�.� _ State Cdr Zip Telephone5-5- , dST SETBACKS REAR SETBACKS FRONT �}, �'�� •1-O PERMIT NO. //t��"t. • (� 6b SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $