HomeMy WebLinkAboutPV2019-061 - Permit ApplicationPrint Form Worksheet for ombo Building & Solar Permit Application 6.6.
(- Comm"Residential City of Newport Beach -Building Division � �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °<•.aa�"
rBuilding r Grading rDrainage F_ Elec r Mech r Plum CuvdCut F Cu Yd Fin I
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use Const Type �-
# Stories[ # Units (if Rest,
9l03 AL' iCECmWfi�r4 Soar-
" e p
! P61M_ 10 /nlG�fZ�i/1✓Q7 YS. -
�7
New/Add SFr— Remodel SF�— Garage/New/Add
Valuation $ 7�/
Materia Lab
OWNER'S NAME Last .. �/Vx� First _G'G1P.hSGR_ jet/
Owner's Address Owner's E-mail Address
-
City �v v6Tjj7i-�-_ CGh State Zip _ � Telephone 9/7-35Z/-3?3/I
APPLICANT'S NAME Last �— First
Applicant's Address Applicant's E-mail Address
j53S /xe✓rcrclt
City LrdState I Zip F_ Telephone 949-230-706/
ARCHITECT/DESIGNER'S NAME Last FirstLic. No.F
Architect/Designer's Address Architect/Designees E-mail Address
City __--- State F— Zip F 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 / /A `` � Lic. No. 601 ` 9'3 Class,
Contractor's Address Contractor's E-mail Address
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City --- -_-.- State G.A-_-_-- zip .K�/ g_, Telephone 9gq-Z3�-A./e
SETBACKS REAR SETBACKS FRONT PERMIT NO. <2-�
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.yI�T� ' 2 of
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $