HomeMy WebLinkAboutX2019-1053 - Permit ApplicationA 2-00 tO6 3
Pint Form Worksheet for Combo Building & Solar Permit Application p" °-t
r Comm'I r Residential City of Newport Beach - Building Division ogy"
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading rDrainage r Elec r Mech
F)ZI Plum CuvdCut F cuv ill F
Project Address (Not mailing address) r Flood
r Fire r Liq r Landslide /A Floor Suite No
F_
59 Victoria
Description of Work
Use FFIR Const Type FB
# Stories. #Units (if Res)I 1
Remodel Kitchen and Master Bath
-- -
Valuation $ F000
Material/Labor
New/Add SFFi Remodel SF 2 Garage/New/Add—
OWNER'S NAME Last Gorman
First Connie
Owner's Address
Owner's E-mail Address
59 Victoria
City Newport Beach State Ca.
Zip 92660 Telephone 917-887-2432
APPLICANT'S NAME Last Lushbaugh
First illiam
Applicant's Address
Applicant's E-mail Address
17191 Citron
blushbau h@ aol.pom
9
Irvine State
cityC
Zip 92612 Telepone949-584-2166
ARCHITECT/DESIGNER'S NAME Last Lushbaugh First illiam Lic. No. 24867
Architect/Designer's Address
Architect/Designer's E-mail Address
17191 Citron
blushbaugh@aol.com
Ciry Irvine State Ca.
Zip 92612 Telephone 949-584-2166
First F Lic. NoF
ENGINEER'S NAME Last �—
Engineer's Address
Engineer's E-mail Address
City �— State �—'
Zip r-- TelePhoneF_
CONTRACTOR'SNAME/COMPANY � �j� G«��L ( � � Lic No. I t01 b�(� Class
Contractor's Address 0
Contractor's E-mail Address
\ i . ����^� a �d�� D
'VAT 4 406 Cx-c.-t
City T��sy�^� -C_l�- State rC-A
Z'p "11 13?U Telephone LA �c�71�6732i
-
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. E>l3 •7 a� �, 1
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $