HomeMy WebLinkAboutX2019-3803 - Permit Applicationr
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Building F C
Address
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of Work
for Combo Building & Solar Permit Application
City of Newport Beach - Building Division X Zooq - 303
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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{ I aluation $ 0
New/Add SFF "r_7 /� Remodel SF 3 � `� ( Garage/New/Add aterial/Labor
OWNER'S NAME I Last I 00 -t -a!'34 Al /l' P_ First jj
Owner's Address Hj4L Owner's E-mail Address
City % %f State Zjp Q2_6 '� I Telephone q_gg> %�&--' _-
APPLICANT'S NAME Last I 15�v)J, -
First I cle-4167
Applicant's
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ARCHITECT/DESIGNER'S NAME Last First' Lic. No. czo/_*c
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Architect/Designer's Address
City State
Architect/Designer's E-mail Address
I
Zip Telephone
ENGINEER'S NAME Last First I M__S/Y?T Lic. No. ,55I I
Engineer's Address
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Engineer's E-mail Address
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Zip Cj'2` % Telephone 7/`t. -z383 -41 J4
CONTRACTOR'S NAME/COMPANY/�L Lic No. ��� Class
Contractor's Address
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CityF<: 1�-- __, State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip Telephone
PERMIT NO.
PLAN CHECK NO.
USEZONE DEVELOPMENT NO PLAN CHECK FEES $