HomeMy WebLinkAboutX2019-1324 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4rE��R,e
F- Comm'I Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading
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Project Address (Not mailing address) F_ Flood f— Fire F_ Liq F_ Landslide rN/ MrTNo
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Description of Work
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# Stories #Units (if Res)
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Valuation $ 2i7 a Vrj/U. ri
New/Add SF +--Cl ^
Remodel SF f DD%tit` Garage/New/Add
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Material/Labor /G+c�.ocw%
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OWNER'S NAME
Last �VINV A9KAKj �_ First
Owner's Address
Owner's E-mail Address
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214 I
City
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State I . --.- Zip 9291lTelephonel
APPLICANT'SNAME
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Last tvlJ/{[6%l l)jo First IOC4 /" Cr
Applicant's Address
- Applicant's E-mail Address
city
State — Zip F Telephoned
ARCHITECT/D
Last r/T First
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Architect/Designer's Address
Architect/Designer's E-mail Address
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Piz,
City
State F_Zip Telephone
ENGINEER'S NAME
Last "w// First kQ 7 if Lic. Noe,70
Engineer's Addre s
Engineer's E-mail Address
17 C GAF
City �Q(�
State Or Zip q'5dZ� Telephone
CONTRACTOR'S NAME/COMPANY �y �c. No. 3lassF_
Contractor's Address
Contractor's E-mail Address
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City 12.�/�ij/�.
State 1` / Zip Z�p%Y Telephone 9 32 -6/ 3
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. b 3,3 u — iy
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 09 :23a6
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
�24K
(2j�$