HomeMy WebLinkAboutX2019-3011 - Permit Application (2)Print Form Worksheet for Combo Building &Solar Perrrs's4 Application ®r,�Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F- Grading (Drainage j_Elec J_Mech ("'-Plum cuvdCut CuvdFill
�
Project Address (Not mailing address) F_ Flood j- Fire F_ Liq r- Landslide F_N/A Floor Suite No
t,SD- 1 cl,Ynonell,
A V -C. F_ 7—
Description of Work
-h- �.J°� i e
Use ConstType79
# Stories .2 # Units (if Res)T
I
Valuation 5 (/10 "�
Material/Labor J v
New/Add SF F_Remodel SF�� Garage/New/Add
OWNER'S NAME LastFCJ{
/j P ! First
✓1GL '
Owner's Address
Owner's E-mail Address
City F" ?�.aa.�,- ���U��
State t_'; Zip,JJ Telephone
APPLICANT'S NAME Last
v�G' First
Applicant's Address
Applicant's E-mail Address
Ccr c 'jam
b' jC,LCCSio� trant� rI� S.C.D
city V,U-H, �.,
State 4 Zip I Cf 06, by
/ Telephone (((f
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State Zip I Telephoned
ENGINEER'S NAME Last �3 �5 y First Hyl Lit. No. y/107
Engineer's Address
Engineer's E-mail Address
q_7 4q- VkA,--ate—
-5-4• " l
City ( Icz) �`; �
State Zip (j ('](Q Telephone &2 ���_, "��„ CS'
CONTRACTOR'S NAME/COMPANY
t /' 7"vs Lic No. l Cep ��t 7 Class C —2
Contractor's Address
Contractor's E-mail Address
tr r2- C e-' V_cGL +t
� ' y'i Fr 'v f'>" �> t G- - r a . (f �D
City L {�L.1, 4- f—,'
State G j� ._ Zip Ll Telephone F & 2— .2
SETBACKS REAR
f
SETBACKS FRONT-"� C
PERMIT NO. i°� �-
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $