HomeMy WebLinkAboutM2019-0040 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
pLC Comm] ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
®Building F, Grading ❑Drainage ❑Elec ❑Mech
❑Plum cuYdCut l
CuYdFillE111
Project Address (Not mailing address) ❑ Flood
❑ Fire ❑ Liq ❑ Landslide
❑N/A Floor
Suite No
12)53 U-Ic� od t `of.
� II
F_
Description of Work
YVl h{�nan(.� •( s:eGtwo,.�
Use F—] ConstType C,
# Stories # Units (if Res)s
New/Add SFRemodel SF Garage/New/Add Valuation $ W �K
Material/Labor
OWNER'S NAME Last Irvine �rypy�y� First
Owner's Address Owner's E-mail Address
city I State Zip F-----7 Telephoner
APPLICANT'S NAME Last I so
First
Applicant's Address Applicant's E-mail Address
31�i5- �h'r t �a�Ata� t� (ha -
city I e0 State .F5iiF Zip Telephone y3rjZ'7�'j
ARCHITECT/DESIGNER'S NAME Last First 17-777 Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
��i
ENGINEER'S NAME Last I Ww-n First I � rWILI Lic. No. — (j6
Engineer's Address Engineer's E-mail Address
775(5 ( I lLe r ^e. Pe. 10(pn (m rAl;-&o Q 6in rPtor ca . coy-n J
Ci -)'IUn•h ✓1 f )C%4-) ' State Zip V_7 Telephone 057
CONTRACTOR'S NAME/COMPAN�,�� Lic 382
No 7,�Class
Y s�
PheK5tf Co.. 'ZhL
Contractor's Address Contractor's E-mail Address
1305 �. �ka�erT PT
- - /n+lce�ws •� jtenso✓i � evv+
�ity _SI &^(AL_ G'r(LL State _ C �Y Zip q 0 7 55 Telephone 5L2 5q5-fi3510
REAR
LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. M do ( I — (`j 0 L{ 0
PLAN CHECK NO. ) 25 3 — 2 01 9
ZONE DEVELOPMENT NO PLAN CHECK FEES $