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X2019-0006 - Permit Application
>CZO1ci 000& Print Form Worksheet for Combo Building & Solar Permit Application oY�E" °Rrm F-] Comm'I ❑ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Nauilding Grading [GlDrainage ❑Elec ❑Mecham (-J Plum Cu Yd Cut[ Cu Yd Fill Project Address (Not mailing address) - lood ❑Fire Liq ❑ Landslide ❑N/A Floor Suite No Description of Work �17�G'LI'SrT%l tc7 ; / J�� I Cr Use .5r]%I Const Type Stories #Units (if Res) Valuation $ 7o_11v Material/Labor /� —���- New/Add SF I S Remodel SFIIII qJ Garage/N w/Add 7 �j , OWNER'SNAME Last '�EE',�. ._.__. First y Owner's Address Owner's E-mail Address / 0,;.2 1 City ')�T06-` - - State I Zip Telephone APPLICANT'S NAME Last J First J Applicant's Address Applicant's E-mail Address City _ F _ I State F771 Zip J Telephone ARCHITECT/DESIGNER'S NAME n / First l j Last lCl/l Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address ' City 09 X7&1 State I 1 tJ Zip /-/_T7 5 Telephone -[— ENGINEER'S NAME Last _ O%�T) rj - _ - - J First Lic.No.6 CC ''__ Engineer's Address Engineer's E-mail Address !_gin �. /'._ 51 City 3 tVT?t AA W„-_-----,.I State Zip li ��- Telephone._ T CONTRACTOR'S NAME/COMPANY Lic. No. °�'3] ` �%1 Class Contractor's Address Contractor's E-mail Address City State � 7 Zip F _ Telephone 1 SETBACKS REAR SETBACKS FRONT PERMIT NO. \moi SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ©1G'U�• Zo i C-1USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ `A "-V57-- - '--'- 4--1-I