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HomeMy WebLinkAboutX2019-0257 - Permit ApplicationWorksheet for Combo Building & Solar Per ipplication F- Comm'I F- Residential City of Newport Beach - Building Division g NOTE:, PLAN CHECK FEES DUFF AT TIME OF SUBMITTAL 5<'0„�•� f-Building j Grading )-Drainage 7EIec rvmech j- Plum CuYdCutF- CuYdFill F_ Project Address (Not mailing address) F_ Flood r Fire r Liq r Landslide 1_N/A Floor Suite No U4 N Pi� F_ 7— Description of Work Use ConstType F_ � � # StoriesF_ # Units (if Res)r- Valuation Material/Laa b � New/AddSF� � modelSFF— Garage/New/Add OWNER'S NAME Last �Q,G� O First ( V ,�q �• Owner's Address Owner's E-mail Address (y � city �('�7,^ State ZipTelephone AAPPLICANT'S- NAME Last - - -/T (�First u/� �tpplicant's y V Address Applicant's E-mail Address City C(,�Vt'261 - State C� Zip l _qa-� q (. Telephone �)� O 2I o c)s � / / '�" ARCHITECT/DESIGNER'S NAME Last FirLic. No. . Architect/Designers Address Architect/Designers E-mail Address City State Zip Telephoner ENGINEER'S NAME Last �L �� �� s€irstLic.No.r 1� Engineers Address Engineer's E-mail Address �(o CC2 �-_Z wl a L — C��_z_0� City -4'n �GA„ State �� Zip / Telephone 3` L V /K CONTRACTOR'S NAME/COMPANY j Lic No. � Class`l� Contractors Address Contractors E-mail Address City State F Zip F_ Telephoner =TBACKS REAR 5 t SETBACKS FRONT PERMIT NO. -- ( Z5 L - �,O BACKS LEFT Lj t SETBACKS RIGHT PLAN CHECK NO. '09Cat- —f ONE C DEVELOPMENT NO PLAN CHECK FEES $ y ( V Print Form Worksheet for Combo Building & Solar Permit Application 04fE o"°a'a F_ Comm'I City of Newport Beach - Building Division S (: Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL y, ildmg F_ Grading (—Drainage r"Elec rMech F_ Plum CuvdCut [_ CuvdFill F_ Project Address (Not mailing address) F_ Flood r Fire i— Liq j— Landslide f N/A Floor Suite No Description of Work Use F_ ConstType �— #Stories #Units (if Res) Valuation$ Material/Labor New/Add SFF_T-PY_ Remodel SFF Garage/New/Add OWNER'S NAME Last C First Owner's Address Owner's E-mail Address �y-� �usft3 �✓,. - - - City _. Iv.w.. _..-(i/ State �. Zip _L (6) Telephone _ APPLICANT'S NAME First FT v/ Last !'12��s�. �- ------ - - . - Applicant's Address Applicant's E-mail Address ._ -76 City State Zip Telephone F/G- / -r2, _; � r T ARCHITECT/DESIGNER'S NAME Last First [rl ` Lic. No. rr''sAddrre�ss Architect/Designee[ Architect/Designer's E-mail Address p City �' i./ � State `(T' Zip � Telephone 3/(/- / ENGINEER'S NAME Last First [ Lic. No.F Engineer's Address Engineer's E-mail Address City State F_ Zip Telephoner — CONTRACTOR'S NAME/COMPANY C/Ut e,� Lic. No. f Q Class �� 1 l Contractor's Address Contractor's E-mail Address 2 a 3 P 3f F��— �ld��celll. City State t- (� Zip C(JTelephone SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES S