HomeMy WebLinkAboutX2019-4031 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application na
j— Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(XBuilding F_ Grading
v
rDrainage r Elec F,Mech r Plum CuydCut CuvdFill F
Project Address (Not mailing address) r Flood r Fire F Liq r Landslide rN/A Floor Suite No
12 Coventry
F �—
Description of Work
Use R2 ConstType VB
Demo Kitchen
and rebuild and
master bath, replace raised floor deck, install new raised floor
panel,iGL R@kY
I' IRG., t a#9 ..+ fixtu Flrepla
# Storiesrl #Units (if Res)r3
gag FL and new ek6tnE Ee
Valuation FOOOO
Material/Labor
bor
New/Add SF�—
Remodel SF 360 Garage/New/Add �—
OWNER'S NAME
Last regor First Robert a-Q�
Owner's Address
Owner's E-mail Address
12 Coventry
City Newport Beach
State Ca. Zip P2660 Telephone 949-729-1040
APPLICANT'S NAME
Last Lushbaugh First illiam
Applicant's Address
Applicant's E-mail Address
17191 Citron
blushbaugh@aol.com
City Irvine
State Ca. Zip 2612 Telephone 49-584-2166
ARCHITECT/DESIGNER'S NAME Last Lushbaugh First kvilliam
Lic. No. C24S67
Architect/Designer's Address
Architect/Designer's E-mail Address
17191 Citron
blushbaugh@aol.com
City Irvine
State Ca. Zip 92612 Telephone949-584-2166
ENGINEER'S NAME
Last First Lic. No.F--
Engineers Address
Engineer's E-mail Address
City
State Zip r Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. F Class r
Contractor's Address
Contractors E-mail Address
City
State F Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $