HomeMy WebLinkAboutX2019-0267 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 07-
r Comm" J9Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
KIBuilding ❑Grading F-Drainage ❑Elec ❑Meth ❑Plum Cu vd Cut Cu Yd Fill
J
Project Address (Not mailing address) ❑ Flood FA -Fire ❑ Liq F-]Landslide❑N/A Floor Suite No
:2oz62 Q dilcl AL._ L__1 0
Description of Work
Use 171 Const Type
G/0 < %�1i0%�7 4446+
#Stories #Units (if Res)n
Ce»7ocle/ l�f�c�e��, d�-�/�orrM «.-d wa,
.-- _ _- - --
Valuation $ G U 700.
Material/Labor
New/Add SF Remodel SF e Garage/New/Add
OWNER'S NAME Last CA First
Owner's Address Owner's E-mail Address
2oz`'2 *Yviei,< Are. - 1cvh�ch.�rg 0 hcfihu,'�,CdrYI
City &,,C -'. State [ Zip c v Telephone
APPLICANT'S NAME Last ��First
Applicant's Address Applliicant's E-mail Address
,r
•" I Z /�' �. V� a:v r•IvC 7C M 0 C1110't d? 1/H/R.7 I CA:"I7
City N 'v*NC`� _ I State l �A Zip I��OC Telephone 9Y"' 3a1-4,r/ L
ARCHITECT/DESIGNER'S NAME Last First c' r
l_ y_GG _J_o Lic. No.
Architect/Designer's Address / Architect/Designees E-mail Address
City L State I Zip C��,yl Telephone jC�_q,-�j�
-- -.hy
ENGINEER'S NAME Last First Lic. No. d'pj�'S
First �I
Engineer's Address Engineer's E-mail Address
.2/O �( M,74-17 r s7✓C,_
-_city 06p/lex
_ State ® Zip Z(6)..� Telephone J�1
CONTRACTOR'S NAME/COMPANY Lic No. F Class
Contractor's Address Contractor's E-mail Address
City - Ii State ! 7 Zip F Telephoned
SETBACKS REAR I G.i SETBACKS FRONT PERMIT N
SETBACKS LEFT CO SETBACKS RIGHT c% PLAN CHECK No
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $