HomeMy WebLinkAboutX2019-3092 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application
( Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES D116 AT TIMF nF Rl IRAAITTAI
]wilding F_Grading F-Drainage rElec (—Mech rplum Cu Yd Cut CuYdFill r—
Project Address (Not mailing address) J_ Flood (_ Fire r Liq r Landslide I —N/A Floor Suite No
(i q y U I -1A L (o c_, N o P-o
F— F—
Description of Work
Use I— Const Type
# Stories # Units (if Res)[ —
_
Valuation $,-
Material/Labor
New/Add SFF— Remodel SF f _—
Garage/New/Add F_
OWNER'S NAME Last Ti rE { I (, A LI o , First
Owner's Address [--IC;u1 2
-; t
Owner's E-mail Address
City (77State Grp -
r _ Zip C {,.�� � Telephoner
APPLICANT'S NAME Last ( L . n
�._. �`_�_aN"rr
n —_-�
JrVc_. First. z,u�N�!t FJcr_,��
Applicant's Address
Applicant's E-mail Address
City F—lj i /-- h / Cc. State L!1
Zi [ c—L JSS- Telephone - -- - 1 -
ARCHITECT/DESIGNER'S NAME Last
First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City w State F_
Zip [ Telephone[ —
ENGINEER'S NAME Last
First F_ Lic. No.r—
Engineer's Address
Engineer's E-mail Address
City State F—
Zip �— Telephone[
CONTRACTOR'S NAME/COMPANY v 7 v.T
Lic. No.
] iC,[. % 1 35 74 Class (3
Contractor's Address
Contractor's E-mail Address
City <] in `�. State (
ZiP C(� 7S_S Telephone S 4 �� 4
SETBACKS REAR SETBACKS FRONT
PERMIT NO.���
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $