HomeMy WebLinkAboutX2019-1954 - Permit Application (2)Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB %
wilding Grading Drainage JyElec , Mech i N lum Cu YdCut (� C Yd Fill ('J k GI) /I
1. U
Project Address Not mailingaddress) F- Flood F— Fire F— Liq (— Landslide XN A Floor Suite N
New/Add SF I L 11 b t O IC)
ode! SF i Garage/New/Add
i
UseConst Type
# Stor��,)# Units (if Res), %
Valuation
Material/Labor
OWNER'S NAME Last i I First
Owner's Address Owner's E-mail Address 1
City / V✓ State 1 �� Zip I � Telephones
APPLICANT'S NAME Last `M eJ\J First
Applicant's Address
City
ARCHITECT/DESIGNER'S NAME
(wit L
'fApplicants E-mail Address
State I —_ Zip Telephone
Last +M r11 ry First 1 U Lic. No. l � /
Architect/Designer's Address Architect/Designer's E-mail Address
j `2 02 S �✓ ° �`' �'� I VOL Y
City State Zip /� Telephone! ott g� _ 7 �)
ENGINEER'S NAME
Engineer's Address
Last
First 1
Engineer's E-mail Address
t ,
J
City , State ? Zip Telephoned
a�
Lic. No.I
CONTRACTOR'S NAME/COMPANY i q Lic. No. 110 �9 Q Class Pj
YF
Contractor's Address Contractor's E-mail Address
i City l IrLV(Ng State Zip 'Iq 2412_ Telephone i q �1 4-1 Z" 3 q10
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. _ ' `-' Q
PLAN CHECK NO.
PLAN CHECK FEES S 8 << (0-1•1