HomeMy WebLinkAboutPV2019-035 - Permit Application�0�trSrrtt Worksheet for Combo Building & Solar Permit Application DOW
City of Newport Beach - Building Division
Comm'l residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ^ 035
I/ Building F- Grading j -Drainage F_ Elec F-'Mech F` Plum Cu ydCut F_ CuvdFill F_
Project Address (Not mailing address) F Flood j— Fire F_ Liq F Landslide FN/A Floor Suite No
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Description of Work /
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l (Q' kUJ I To DOS Z Jrwo-kyw 1'0 2' Dy ft-ft,T # Stories[ # Units (if Res)
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JValuation 5 rLt p� p
New/Add SFF— Remodel SF F— Garage/New/Add FI Material/L or
OWNER'S NAME Last r �(� _ First WciAd
Owner's Address Owner's E-mail Address
j q(0(5 Offtt qvA U.
Citycav-,� ( mom.... State �-' Zip 1 0&@ 25 Telephonel�
APPLICANT'S NAME Last W First I se�
Applicant's Address Applicant's E-mail Address
_q 33 ,N«a6t�t,Gl Sj- __ �>e� b�,�leFlr�esola,,r.cewt.
City 1 C(S4-0, YIVAA, State I a" Zip CjZ6,Z7Telephone9y9J32ro-3lro2-
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City State
ENGINEER'S NAME Last I l/
Engineer's Address �J�f
12-0-751
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City I State
_... First ( Lic. NoT;
Architect/Designer's E-mail Address
Zip F— Telephonel�,
First I b I
fl oLic. No.[—
Engineer's E-mail Address `�
Zip FqZ6 ir(Q. Telephone[�tp 5- 5-/ py _.... _.
CONTRACTOR'S NAME/COMPANYsr�)-.-6A!So� Lic. No. /62 2 ?Class GL/(ora
Contractor's Address
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city F__E0s4e, Vkeaq, State
SETBACKS REAR
SETBACKS LEFT
Contractor's E-mail Address
Zip %1-62-7 Telephone g0& 41$9- 3$33
SETBACKS FRONT PERMIT NO. T %1111�yV %-1
SETBACKS RIGHT . Ol PLAN CHECK NO. (Rr&5 I ..
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $