HomeMy WebLinkAboutX2019-2774 - Permit ApplicationWorksheet or Combo Building & Solar Permit Application
r! Comm'1 F, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Preyed Acidr'ess it i9i'"mailing address) F •Hood r Fire r Liq i Landslide r7',hl/A Floor Suite No
2507 A,largare�, DY%ve,
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Description of Work
Use $; R Const Type v 6
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Material/Labor
OWNER'S NAME Last
First
1 J
Owner's Address
Owner's E-mail Address
City NV�%�l` 6e0� State CA.... Zip--! Telephone 9l.,L Ll Idl --�
APPLICANT'S NAME LastRIChart First iJason
Applicant's Address
Applicant's E-mail Address
1041 W. 18th St, (A106)
1 Jason@dchartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 949-422-9191
ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
1041 W. 18th St, (A106)
Jason@dchartdesign.net
City Costa Mesa State ICA
Zip 92627 Telephone�949-4291
ENGINEER'S NAME Last WANKET
First FNEAL Lic. No.
Engineer's Address
Engineer's E-mail Address
3020__blc�c4de&rLwP, &+C.Z04
w 9";sleer;n,5.com
City TEMECULA, State CA —,
Zip 9259 0 Telephone qr l _ b� ( I_ 6 7�P3
CONTRACTOR'S NAME/COMPANYL xcv Lic. NoOr Class
J�Sg
Contractor's
Contractors Address
E-maildrass
'. mCJ r...Lwa v 'LC �j ;,., 5 •r vLttstfT'-Lo.n.. C -o <..... '.
City } � .5� �0! State -,
Zip G� y� Telephone 1 W62 9 50 5
SETBACKS REAR i la SETBACKS FRONT
y�
'yam Y PERMIT NO. 1/� 0- 74
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE `C DEVELOPMENT NO
PLAN CHECK FEES $