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HomeMy WebLinkAboutF2019-0672 - Permit ApplicationForm Worksheet for Combo Building & Solar Permit Application v Comm'I Fv- Residential City of Newport Beach -Building Divisiot� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBI�y TAL U rBuilding (- Grading rDrainage r-Elec Fv_l ech r Plum CuYdCut ©4 QYdFill Project Address (Not mailing address) i- Flood r Fire r- Liq j- Landslide /A Floor Suite No boy yc r . 13m,*OA BL-v l> h1EW tojz7 f q C7 ",A • Ca Description of Work e aynstType F F # Res)[ %if Valuation $ 1-31,0-717 Material/Labor New/Add SFRemodel SFF_Garage/New/Add OWNER'S NAME Last First Owner's Address Owner's E-mail Address City State F Zip F— Telephoned APPLICANT'S NAME Last I gyp($!.,-eS First Applicant's Address Applicant's E-mail Address 3-ISO Initxl3TM1 AvE /NvZftN- • FRCh(,,►-ES igvj S F P. v S City I t„-�W pot] State C� Zip 90'7 12 Telephone Sle2.1-19 • O-%? O ARCHITECT/DESIGNER'S NAME Last First Lic. No. �— Architect/Designers Address ArchitecUDesigner's E-mail Address City State I Zip F— Telephoned ENGINEER'S NAME Last First _- Lic. No.F Engineer's Address Engineer's E-mail Address City State F— Zip Telephone[ CONTRACTOR'S NAME/COMPANY Werrew4 K L2 T IC Lic. No. y$$$SIC, Class G• I(o Contractors Address Contractor's E-mail Address 3'IZA 1ti1Dv5tl� putt Svt-`F�#1 / �rcl-•Rcr3t�IgWSFp.%JS City LpKt�_;V40E �> State I "r' — Zip `(O-I I-4- Telephone t ,I--Iq . p-7-70 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.zff:r.7 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $