HomeMy WebLinkAboutX2019-0625 - Permit ApplicationPrint Farm Worksheet for Combo Building & Solar Permit Application
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�, City of Newport Beach - Building Division _
Comm'I Residential
NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X no1Q1 Ul7
(-'iBuilding F_ Grading F'Drainage f-.Elec [-IMech
',Plum CuvdCut �, cuvdFill F
Project Address (Not mailing address) [ Flood
F_ Fire F_ Uq F_ Landslide I -N/A Floor Suite No
F!; I
Description of Work
Use F—ConstType F
Stories # Units (if Resf
Re. �aei �x-fir..�;or� Pootr'uPvt C,Ua�dr^4;IS
Valuation $
New/Add SFF I Remodel SF[ Garage/New/Add F —
Material/Labor
OWNER'S NAME Last r �� �i�r21� 1J l� � C} �t� r �-First
Owner's Address
Owner's E-mail Address
I
City � _ State �—,
Zip F, Telephone—;
APPLICANT'S NAME Last r'-,A n 1`; V v ��� ��, �'T AJ)/�irst
Y
Applicant's Address
Applicant's E-mail Address
l lL ivLU u,21 _ l r
�t/�Z� �tL�-/a.L0
city i �. �; {�{.`,� '� I'2 l= %�LI ( State c_n
Zip t F&_& uI Telephone ct ; (S -f zv- v
ARCHITECT/DESIGNER'S NAME Last F -
' First Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City [— State �
Zip �— Telephone[—
ENGINEER'S NAME Last o C 0 N N r LL I First I<� V I N Lit. No. S 4F? 07
Engineer's Address
Engineer's E-mail Address
I150 S.OLIVE ST 5,01TL 1600
krtocoviozC-0w
City L(�S fiI.1(yr L. s State EA
Zip qOD f Telephone ,17j a?I-a000
CONTRACTOR'S NAME/COMPANY � Lic. No. 'n 2C{j C( I Class m� cu< Eh�
Contractor's Address
Contractor's E-mail Address
zb 101 e1z. 133
fvme fdmconitOc4lt)al Com
City ged�as State I
Zip �� 0 3 I Telephone ?IN- 4oy - 8� 4q
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ��, O I(J�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. tJ�NUi Itil"1
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $