HomeMy WebLinkAboutX2019-1222 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I t- Residential ( / City of Newport Beach - Building Division X.20/Q - 1,2929
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �<,wa.•*
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Project Address (Not mailing address) r Flood r Fire r Liq r Landslide N/A Floor Suite No
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Description of Work
Use (G-3 Const Type x(-73
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# Stories # Units (if Res)
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V nation
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New/Add SF Remodel SF 7 5.117,q5 S., Garage/New/Add
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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State Zip dl y�� Tele hone
p °l ei- 677- 64 l6
APPLICANT'S NAME Last
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5T,44o First jCF�I€
Applicants Address
Applicant's E-mail Address
Z TACtPl 114
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city Auto Ott1jp
State I �' Zip � 56 Telephone �t�C_ 6-]7•13U4-
ARCHITECT/DESIGNER'S NAME
$iANO tweAfeels'eAc.,
Last First 3rstE LicNo. e-29815
Architect/Designer's Address
Architect/Designer's E-mail Address
Z Eelna
Si%IE& 5-C4�6A-siah-Mcr5. e_�j
City lkst; 0%qu
State 5 Zip FZ(,% Telephone -141i-6-m-ojw
ENGINEER'S NAME Last
��t}pOs Firstr� ,f Lic, No. 570-%
Engineer's Address
Engineer's E-mail Address
tel\Int-se*j-DradE
SulaF 450 ►�l\Sov0138 t3c¢rVt, eor✓y
City I Wo4r
State CA Zip g2G1-Z Telephone jjC_ 75Z--0601
CONTRACTOR'S NAME/COMPANY
J 7J���/�� NC / Lic. No. Class
Contractor's Address
66ltractor's E-mail Address
cityM/ State F Zip Telephone
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SETBACKS REAR
SETBAC FRONT PERMIT NO.
SETBACKS LEFTS/�Q
GHT PLAN CHECK N .
USE ZONE
VELOP NT NO PLAN CHECK FEES $