HomeMy WebLinkAboutX2019-1934 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F�/l'lum Cu Yd Cut Cu Yd Fill
F- Flood r Fire F_ Liq F- Landslide F_N/A Floor Suite No
Fr7Building F- Grading F-Drainage
Project Address (Not mailing add
30� AUGIVfDA Caws
of Work
New/Add SFF !hy- Remodel SF1 7 Garage/New/Add F-
Use i ConstType U'1
# Stories # Units (if Res)[—
Valuation $ W
Material/Labor
OWNER'S NAME Last FirstF-04ee�
Owner's Address Owner's E-mail Address
30f fvailm colecos D
City -h�jl `Ei State ���-- Zip �z(p& Telephone %f 9- 3aj - W
APPLICANT'S NAME Last Iul
Applicant's Address
�123 (.i CPS fro r
City State
First
Applicant's E-mail Address
Zip CJ'�(jr$ 3 Telephone fig - S73
ARCHITECT/DESIGNER'S NAME Last ��� First I)NU Lic. No. C 77&to
Architect/Designer's Address
Dz- o I
City F`44_ (1J� � State
ENGINEER'S NAME Last
Engineers Address
2; irSJ C%20164D 19)2 O Z
City �,5 State is
CONTRACTOR'S NAME/COMPANY
Contractor's Address
Architect/Designees E-mail /Adddres�s
n"
Zip 7q073 Telephone QW7S M
FirstlAftai Lic. No.I C837S3
Engineer's E-mail/Address . A
Zip j5, VTelephone '7lcf-�%(�
Lic No. F_ Class
Contractor's E-mail Address
City
State F— Zip F—
Telephoned
NO.
SETBACKS REAR
SETBACKS FRONT
PERMIT
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
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