HomeMy WebLinkAboutX2019-2099 - Permit Applicationlg� f � 7vla - aoei - ugcf
Print Form Wg"heet for Combo Building & Solar Permit Application
WComm'I r Residential I(\) City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r- Grading
Drainage V(Elec j,�Mech Plum Cu Yd Cut Cu Yd Fill
Address (Not
mailing address) F_ Flood r Fire (-! Liq F7 Landslide Floor Suite No
fProject
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Ne} V4r - 13t-ic-1% cA 612.Gi�GGS�,,� ,, CI}���
Description of Work
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Use . }�� Const Type I Q
# Stor' # Units (if Res)F
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Valuation Fi
Material/Labor ^t(�ta^•
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New/AddSF�
Remodel SF 25i, 653 Garage/New/Add
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OWNER'S NAME Last (L C l First \ ie �'wr 1G
Owner's Address
Owner's E-mail Address
(15 Irg. �$+ S'}.
...State
City 1Uz„-, �I�,, 1� _
zip ICiQ —1k Telephone �22-4t'-t-58i10
APPLICANT'S NAME i
Last 1�4v....ccles.,(C-•o.. __.1 First $o t,(,e-. __. _...
Applilicaant''s�Addrlelss
Applicant's E-mail Address
\/ �j I
555 'ri- JY" S+. J54`IIP✓!
city .i gs, A, -a' -Lr s
State I - Zip �Socl3 Telephone
ARCHITECT/
Last r ``,11 QQ � First a% Ffc. No'
A cUDesigner's Address
'- Architect/Designer's E-mail Address
ck6o Alla, r Ave
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City i�lEa.-, �>t
State GA zip .�45o1� Telep�lo-.1665--Id 3
ENGINEER'S NAME
Last First F Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip I Telephone
CONTRACTOR'S NAME/COMPANY ^ Lic. No. j0?iYi�5i� ClassF
Contractor's Address
Contractor's E-mail Address
Q00) �1��;,\ S k
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...State
City RZ,go; � t9c 1AI
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7 Zip ri1 Ll0<o. _...Telephone qT-tilt _Q9)b.
SETBACKS REAR
SETBACKS FRONT PERMIT NO. k N
TB KS LEFT
SETBACKS RIGHT PLAN CHECK N r ��,
0 E
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DEVELOPMENT NO PLAN CHECK FEES $ 01 i