HomeMy WebLinkAboutX2019-3341 - Permit ApplicationVUorksheet for Combo Buildin X20qOW
J & Solar Permit A llo q4
City of Newport Beach - Building Division pp a lon
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
ping I -Drainage F Elec F Mech F Plum c Yd
ess (Not mailing address) F Flood Fire
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an of Work 71-2.0
PATrd.. A
,dew/Add SF� ---�
OWNER'S NAME
DUFL
u Cut
Landslide
Cu Yd Fill I
FN/A Floor
FSuite No
Use Const Type
17
# Stories °: d ''' # Units (if Res)[_
Valuation $
Material/Labor 2 60, O_VU
Last I Ff.SCkAE'Pi—.._.._..._.... . First J�
Owner's Address
FF
owner's E-mail Address
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City ���� �JG�„ State � 0 � � ® �q � • C�' `"�
�� Telephone
APPLICANT'S NAME
Last�L First Q A
Applicant's Address f
�2 ��� /L Applicant's E-mail Address
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City IY ���1�'� �� 1.�..�j State
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Zip I -t 13�, Telephone �CQ'%iG®
ARCHITECT/DESIGNER'S NAME
Last ��� ��\ f�, First
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Arch itect/Designers Address Lic. No. C t -ls z
F_ Architect/Designer's E-mail Address
el SFJ Z3 1-2 5F Garage/New/Add F-�-Q-
City
State F Zip ' TelephoneF---
ENGINEER'S NAME Last-�
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Engineer's Address 5.�.� 2 }-� N First � `Lic.
NEngineer's E-mail Address r�
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City v VLL X,C P_State G,A► n ViS7
Zip —t I S (p Telephone
CONTRACTOR'S NAME/COMPANY
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' Contractor's Address t `� l ��-��
Contractor's E-mail Address
City
State [' Zip �`_.._.._...
TelephoneF---
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO. x� 19 --�
SETBACKS RIGHT
E '�SEZONE PLAN CHECK NO.
,
DEVELOPMENT NO PLAN CHECK FEES $
IN