HomeMy WebLinkAboutX2019-0820 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oown-13>-e
City of Newport Beach - Building Division Comm'I (- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r
r Building r Grading rDrainage ` A lec Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F Flood j Fire [_ Liq [_ Landslide -_N/A Floor Suite No
Description of Work
Use F Const Type
x r
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# Stories # Units (if Res)F
Valuation $
Material/Labor
New/Add SIF Remodel SF ✓/OC Garage/New/Add
OWNER'S NAME Last
�/]` C,/ First F Z_ (/C/f�%(l
Owner's Address
Owner's E-mail Address
nity
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City �—
State F_ Zip F_ Telephoner —
ARC' Ir.zC-. /DESIGNER'S NAME
Last //<,/ First Lic.No. I
'
Architect Designers Address
ArchitecUDesigner's E-mail Address
City 1 .5- /7Gl��t
State Zip 9 Telephone 7i� �6�-�� %G
ENGINEER'S NAME Last
First �� Lic. No.
Engineer's Address
Engineer's E-mail Address
City
State Zip �— Telephone��
CONTRACTOR'S NAME/COMPANY
1 /1 / �N/�s--ai-� Lic No. F:13 ClassFT�_
Contractor's Address
Contractor's E-mail Address
Gv—AUK�iL, Co v�
City I L
State G Zip eT j y Telephoneq"^3,,6—Z-7Zj-
1
SETBACKS REAR
''77
SETBACKS FRONT !i U PERMIT NO x 4al q O
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. i
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $