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HomeMy WebLinkAboutX2019-0523 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application gdog-,"', r Comm'I ResidentialCity of Newport Beach - Building Division 274® ,2®66 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL t{�/q.�j'q? wilding F-1.Grading -..- (-Drainage ❑Elec ❑Meth [- Plum Cu yd Cuts- Cu Yd F�l [7 F7 Project Address (Not mailing address) ❑ Flood r -j Fire i] Liq f7,, Landslide ❑N/A Floor Suite No --�- ---- — -- — ---^ Description of Work Use JI Const Type p fN) # Stories #Units (if Res)sl Valuation U '� New/Add SFF Remodel SFF" Garage/New/Add $ Material/Labor OWNER'S NAME Last I �L-tNip�2 �C..C. First Owner's Address Owner's E-mail Address ,j - ----- M_ qT © G21YLnrtcL _ w �.. City _.:ti.1�vtDiLi _ �3.r�Z.�-�---- f�� State -_ C.4 -I, Zip �C� Telephone APPLICANT'S NAME Last /� A (L.T ��% First _.---✓--._-�-_. __...---------------� ------ Applicant's Address Address Applicant's E-mail Address City - J i State �� , Zip [ _ Telephone ARCHITECT/DESIGNER'S NAME Last � First �I Lit No Architect/Designer's Address Architect/Designer's E-mail Address City - _- -.- -_ -- --._ - - -'I State L J' Zip 7 Telephoned; ENGINEER'S NAME Last CF(Avt First Lic. No. Engineer's Address Engineer's E-mail Address --- -- — -- -- ---- – — — J us A, . A0, vu A IC - C City StateF771 Zip I ' Telephones CONTRACTOR'S NAME/COMPANY Lic. No. � Class s Contractor's Address Contractor's E-mail Address LA,IZ('otJ1j:_S-6N5 .w✓�__ City LA _—_ - _--� State F^ 7 Zip yout,S_--.JTelephone r. SETBACKS REAR SETBACKS FRONT PERMIT NO. TV SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ PS