HomeMy WebLinkAboutX2019-1229 - Permit ApplicationPrint Form Worksheet for Combo Buildi%g &Solar Permit Application
F Comm'[ FXResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
�uilding ,Grading (DrainageElecMech Plum cuY,aC' CuYdFill O
Project Address (Not mailing address) f- Flood F_ Fire
1201 Do1ph%n-Tet-rc�ce _ �
Description of Work
e&O-A c4T a Vnew siv%,6\e �ravn�ly remi4xroe w /
N- 4-or cn��V, Ce.
Landslide /A Floor Suite No
New/Add SF -152(c Remodel SF _ Garage/New/Add 85ro
t.Mechati�O,t
OWNER'S NAME Last
D� er \rvire LI r- First
`I
Owner's Address
a 9 0 l W• Goa�r ian��nw�ty # 20 0
City N ewe oc-r P_ G\r, State 6r
Use SPD Const Type V B
# Stories[-2-# Units (if Res)(
Valuation $
Material/Labor ►�5�0� ��0
U0 9 If 0,
Owner's E-mail Address
`m al\ Lor�1
Zip-`2Co(o3 Telephone'���-
IAPPLICANT'S NAME Last l e"r-k First Mar-Hr�
Applicant's Address Applicant's E-mail Address
q10 O\.� .
city State G1Pt
Zip g2(cC.s Telephonelq;q-(p45-585�
ARCHITECT/DESIGNER'S NAME Last
First � m, Lic. No. C ci( 1k
Architect/Designer's Address Architect/Designer's E-mail Address
'170 a\d, 1vcwFftr'\r F3\-4a.
Fern a►il (F.,
City �e,-oeo - F ah State � Zip q 21ptc3 Telephone ° "t- (o4"ISS4
ENGINEER'S NAME Last First Fad Lic. NofC-�g"13�
Engineer's Address Engineer's E-mail Address
y 10 C� eddda-c� S � eke 200 �ac�. \n q�eti rc►
y @ -�'rnhecwJ;ree�roJ . Govan
City \rv;re State Gjc. Zip TeIephonegl{q-y2.2--\65
CONTRACTOR'S NAME/COMPANY Lic. No. 1O2 ;Class
Contractor's Address V
Contractor's E-mail Address
cA W ZOO j (P 01--
FTA �&&Myw I/ K\, A- �kt % (,,�
City
*uq Yo State Zip r�F� 2 Telephone
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $