HomeMy WebLinkAboutPV2020-178 - Permit Applicatione� Un i1�
Print Form Worksheet for Combo Building & Solar Permit Application
F Comml r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jXBuilding r- Grading r -Drainage r". Elec j-Mech r- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f" Flood rFire r- Liq r-', Landslide (-N/A Floor Suite No
1310 Galaxy Drive, Newport Beach, CA
F F_
Description of Work
Use F—ConstType
top P7 syst em i nst al I at i on of 32 PJ panel s & (1)
1 neer t er
# StoriesF_ # Units (if Res)[—
Valuation $
Material/tabor 000
New/AddSF[__- Remodel SFF —
Garage/New/Add—
OWNER'S NAME Last y tba
First anal
Owner's Address
Owner's E-mail Address
310 Gal axy Or i ve
i anaj 1 an of mi I. com
City I Isvpat Bleach State Zip P266� Telephoned
APPLICANT'S NAME Last i I i p
First Fft
Applicant's Address
Applicant's E-mail Address
Val I ey 13 vd
reevd t l asd ar @jv! 1. can
City Flosermad State CrA—
Zip 710 Telephone 28-297-0163
ARCHITECT/DESIGNER'S NAME Last Iseman Firstri stq)�--
� Lic. No. 1939
Architect/Designers Address
Architect/Designers E-mail Address
1452 M a Rancho San Ci ego
hri s&abi tuseng near rxj can
City Caj on State
Zip 2019 Telephone 9-928-9695
ENGINEER'S NAME Last r ^_. -^
First I Lit. No.F_
Engineer's Address
Engineer's E-mail Address
City � State f
Zip I—_ Telephoner
CONTRACTOR'S NAME/COMPANY ree Md t Ula, I no
Lic. No. Class F" 0
Contractors Address
Contractor's E-mail Address
�zC5 Cixk st, #310
owl ti asol ar ti#Tai I . cam
_._.....�........_..,._...
City I m alF_ert State
ZiP 2211 Telephone 331 x(}52
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �-
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. fAA r
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $