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HomeMy WebLinkAboutX2019-1282 - Permit ApplicationENGINEER'S NAME Last A t til First 0.G Lic. No. 13 1'3 Engineer's Address Engineer's E-mail Addr ss 2_0D City JC�� I State Zip Telephone c(C 1 2A,&- X86 CONTRACTOR'S NAME/COMPANY I Z� a ��& _ Lic. No. Class® Contractor's Address Contractor's E-mail Address City 1!-G�it�_f_6 State C¢d Zip-lZ/fi_7L Telephone SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ X zol - 1292 Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division a g ❑ Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL l"Wilding ❑ Grading ❑Drainage ZElec ❑Mech ❑ Plum CuvdCut � Cu Yd Fill o PTroject Address (Not mailing address) ❑ Flood Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No T3 (e &x f-, JA q r 0 Description of Work Use np 3 Const Type V_6 # StoriesO #Units (if Res)© Valuation $ o*a Material/Labor D , Z7C . `— u ash �L, �e L6 t c s f e Ls CP_ 1 iAQ kS cS A �� "� New/Add SF Remodel SF � Garage/New/Add OWNER'S NAME F Last M� `pC", First e� Owner's Address V? 6 Owner's E-mail Address CZCaxeI ��. City t- State C Zip Telephoned APPLICANT'S NAME Last First Applicant's Address I Applicant's E-mail Address City State Zip qZ(�j Telephone _ ` Cm _ �- SSD - iz _o I I ARCHITECT/DESIGNER NAME Last _ First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City I ::7] State F Zip Telephoned ENGINEER'S NAME Last A t til First 0.G Lic. No. 13 1'3 Engineer's Address Engineer's E-mail Addr ss 2_0D City JC�� I State Zip Telephone c(C 1 2A,&- X86 CONTRACTOR'S NAME/COMPANY I Z� a ��& _ Lic. No. Class® Contractor's Address Contractor's E-mail Address City 1!-G�it�_f_6 State C¢d Zip-lZ/fi_7L Telephone SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT PERMIT NO. PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $