HomeMy WebLinkAboutX2019-2460 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application aF�6
C- Comm'[ F-ResidentialCity of Newport Beach - Building Division ��� 7 - 'I ,�,t /
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V `+ ,oar"
Building F_ Grading rDrainage )(Elec )k-Pech
Plum Cu Yd cut Cu Yd Fill F_
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Project Address (Not mailing addre $) [ Flood F- Fire F- Liq r- Landslide rN/A Floor Suite No
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Description of WorkCt�S
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Use F_ Const Type I
# StoriesT # Units (if Res)F'
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Valuation $ ' U
Material/Labor
New/Add SF� Remodel SFF;�i Garage/New/Add F
OWNER'S NAME Last V. y �
First Yl
Owner's Address
Owner's E-mail Address
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City (`.).��. �.�- _ _ . _ State
Zip C-tc Telephone ���,�-
APPLICANT'S NAME Last C\ j
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Firmest^ Ol h j.
Applicant's Address
Applicant's E-mail Address
City State j
Zip I Telephone i Y 5,T `\ ,sl
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ARCHITECT/DESIGNER'S NAME Last
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First
� LtC/1/ Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F
Zipr Telephonel
ENGINEER'S NAME Last\IG
First Lic. No
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY T�Qh�CYSu.�SGrS
OVC ic.No..I�S�_S� Class
Contractor's Address
Contractor's E-mail Address
City (,. �Q State �—
Zip C� Telephone p L71c,` 1l,-
SETBACKS REAR SETBACKS FRONT
PERMIT NO. LM Uklo
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NOM
Ih I PLAN CHECK FEES $