HomeMy WebLinkAboutX2019-1585 - Permit Application�2VI- 1596 -
Worksheet for Combo Building & Solar Permit Application
F-1 Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
M,Building F_. Grading f—Drainage V!Elec jQTMech fWPlum Cu Yd Cut li Cu Yd Fill'
Project Address(Not) mailing address) r Flood I— Fire r Liq f—! Landslide [N/A Floor Suite No
Description of Work
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#Stories #Units (if Res)
j Vd /�ys'� � t /1/� / a Pr�n� inn., Pals
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Valuation a j 7 ^� �� �l l
Material/Labor J 7/
�=Z� a g o SSTs ��� 3
New/Add SF� Remodel SF/ Gara e/New/Add �-
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OWNER'S NAME Las` �JI/� l First
Last (✓7 ��
Owner's Address Owner's E-mail Address
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City �(/�nIP� 6&ljC_ State 74 Zip Telephone 7// �cj'-y�
APPLICANT'S NAME Last�j__..- _......._. 1 First./ ....... _...__.. __
Applicant's Address Applicant's E-mail Address
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ty i//M/ State Zip �j� / Telephone f/:% ��/-) y� 7
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ARCHITECT/DESIGNER'S NAME Last % Y FirstLic. No.
Architect/Designees Address Architect/Designer's E-mail Address
City State Zip Telephone 07, ✓ / �ry / �`j'
ENGINEER'S NAME Last _ _ First F Lic. No.�!
Engineer's Address Engineer's E-mail Address
City State�',, Zip F Telephoned;
CONTRACTOR'S NAME/COMPANY Lic. No. z 51/y Class
Contractor's Address Contractors E-mail Address
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City ,��. _-. State Zip SZG� elephone %
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Z V --
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $