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HomeMy WebLinkAboutX2019-2391 - Permit ApplicationX 2-0M - Z?A I Worksheet for Combo Building & Solar Permit Application Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r Building Grading [—Drainage r ec t ech P m cuvdcut[ uvdFin Project Address (Not mailing address) F_ Flood j— Fire F_ Liq F_ Landslide /A Floor Suite No Description of Work Use ConstType / H O f,4 L C-0� 7(Lv Ct W` Com/ 4 Q!! f J 1 # Stories #Units (if Res) �'1 v o Valuation a I Material/Labor New/AddSF�� RemodelSFF – Garage/New/Add OWNER'S NAME Last N C �f �' rJ First ' E K� i -/\J Owner's Address Owner's E-mail Address P. 0. BQ)K 0)9( NEED MD D YO 00 , CCDM city .��' r G _ State —', ZiP Telephone J �, 9 513 APPLICANT'S NAME Last /J uwe– 0,5 Ovrw First Applicant's Address Applicant's E-mail Address City _ State – �" Zip' Telephone— N I ARCHITECT/DESIGNER'S NAME Last o L S F lV First FP U L Lic. No. 5 Architect/Designer's Address ArchitecUDesigner's E-mail Address 1050 ROD ST(zgCET PAUL, o(,�:E(v, /}RCH(TFCT ,�) CN(AI(--t cots __5 City A L(- p o u(:--- State Zip _ 9_f©2 g Telephone C-7(o(j) C U --0) ENGINEER'S NAME Last -DAILi- First `i'1�-- Lic. No. ?j 71 J� / Engineer's Address Engineer's E-mail Address so City State �– Zip �- Telephon14T.0—A1030 CONTRACTOR' N@ME/COMPANY —T Lic. No. Classl r-bal 0 CslvtiT�f toN . I �?i ���;.,;.a 11b Contractor's Address Contractor's E-mail Address zaS3o r�SC,►.pe. r F'�,pt-}�� t�pp�j�., City I C"00 {*Nui. State I .r Zip1�r %Fj, Telephone 6 � �a °° / SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ✓ l USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ /