HomeMy WebLinkAboutX2019-4024 - Permit Application27 27 — 2ol
Print Form Worksheet for Combo Building & Solar Permit Application GwPi
City of Newport Beach - Building Division
' Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading j`Drainage I—Elec rMech j—Plum Cu Yd Cut F_Cu Yd Filll
Project Address (Not mailing address) F_ Flood F_ Fire r - Liq r Landslide FN/A Floor Suite No
pW001Ar' is
F
R)AC«C.
e !.W
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Description of Work
Use F—ConstType F_
# Storiesr— # Units (if Res)[-
11
1 G1�1cwN� r1A OMOt/2Ypl A ✓t� '1� $ 1
rn
11d C1^F+1
1, Ai coN �nj k odd l
sro e.: iold6
New/AddSF� Remodel SFF—
Garage/New/Add
Valuation 5
Material/Labor
OWNER'S NAME Last IrVlN2 coryt�A4 First
1...
Owner's Address
Owner's E-mail Address
5.50 N Do ciii 4ex D rn iiie.
City �� '�,� r✓/\ State � Zip 2 (P r?O TelephoneF—
APPLICANT'S NAME Last t GrCL
First
Applicant's Address
Applicant's E-mail Address
Sigs a. Pirpo(4 Loaf 1Dr.
'tY"te,.0(077y/ koo.ro" -
City I`O1 1'�SA State I(,f�
Zip q'j(P21p Telephone �Iq. 2(,1_ $0q.q
ARCHITECT/DESIGNER'S NAME Last 6 soA
First Fmt c kzto Lic. No. '
Architect/Designer's Address
Architect/Designer's E-mail Address
3\q5 5, Lvep Dr,
robrnson@ rVia ivnc. ()et
City &-Ja • t-sm State I CA
Zip gi_ Telephone 1A--ms-aen
ENGINEER'S NAME Last �
First F_ Lic No.F_
Engineer's Address
Engineer's E-mail Address
City State �—
Zip Telephone��
CONTRACTOR'S NAME/COMPANY
Lic No. F ClassF
Contractor's Address
E-mail Address
City State F_
jContractor's
Zip Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT N
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
j
__ Pent Form Worksheet for Combo Building & Solar Permit Application
[; Comm'I [ Residential City of Newport Beach - Building Division
NOTE, PI AN r.HFrV PPPe ni io AT noel 11 ... ,.,..,.
❑Building [Grading
❑Drainage ❑Elec F,, Mech [Plum Cu Yd cutl Cu Yd Fill `!
Project Address (Not mailing address) [ Flood [j Fire [ Lict [I Landslide ❑N/A Floor Suite No
!
j �a I.✓oad�
!i,• 1
��..� 9 � � r� '
Description of Work
Use ConstType
17,
es d .,
z , :d-.^ .� �
# Stories Ci # Units (if Res)
New/Add SF
Remodel SF rrrrrr------���------- Garag �I Valuation a
Material/Labor Garage/New/Add
abor E
7S
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
a,•<i'
��
State Zip `124L 4 Telephone
I
APPLICANT'S NAME
Last First (�ci1S
Applicant's Address
Applicant's E-mail Address
City -� State . ,, --
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last ,✓
/_`l�iij(�y. � First
Lic. No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
.1
city —1��-.
State �7� � Zip !'"���cG � Telephone7i,. 4
ENGINEER'S NAME
Last First
_ I F Lic. No.
Engineer's Address
Engineers E-mail Address
-- I
City [_ State—:.. Zip Telephone!
- _ _ -
_
CONTRACTOR'S NAME/COMPANY Lic. No. 9Zi( Class
3
_. lc✓ J
Contractor's Address--
Contractor's E-mail Address
.� �I 7
City IC..,,.i*c .r���e.�_ State Zip ! lephone cj.iq�%y`ri�i
l-=
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $