HomeMy WebLinkAboutX2019-4090 - Permit ApplicationPrint For WpC jgeet for Combo Building &Solar Permit Application CAP
Comm'I ¢Residential �\ City of Newpo t Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 'j
Building ❑Grading ainage ❑Elec [Mech 7Plum CUYdcutl Cu dF11 I
Project Address (Not mailing address) [I Flood [I Fire rj Liq ❑ Landslide N/A Floor Suite No
Description of Work ��
ailil Use ConstTypeYi 1 )
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1 # StoriesC # Units (if Res)
Valuation $ _
New/Add SF�, R odel SF Garage/New/Add E Material/Labor ?
OWNER'S NAME Last ` First
Owner's Address Owner's E-mail Address
City G'.�r�aa2 r E '✓3 C I State C� , Zip 7�; Telephone Q ' q�?- 7
APPLICANT'S NAME Last (EHT/�E[2/j,CL- First
Applicants Address Applicant's E-mail Address
City /7LfnrW.(r%7/1/ f/C,}�./f State C-+ _ Zip r� Telephone ?/�/7/'
ARCHITECT/DESIGNER'S NAME Last
C) 1 First ZA•(i(r i Lic. No.
Architect/DeArchitect/DesignersAdde�r//e��ss Architect/Designer's E-mail Address
5ii
City State �'�, Zip Z 7U� Telephon 7/
ENGINEER'S NAME
La Fir Lic. No.�
Engineer's Address Engineer's E-mail Address
City _' State Zip F Telephoned
CONTRACTOR'S NAME/COMPANY �fiTl-�F� �aNSI�iC"T2U^' Lic No.R3'/�� J ClassE
Contractor's Address Contractor's E-mail Address
City State Zip g' i j Telephone '7/(/
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T CKS REAR SETBACKS FRONT PERMIT NO. �L ["��h CKSLEFT SETBACKS RIGHT PLAN CHECK NO. ONE DEVELOPMENT NO PLAN CHECK FEES $