HomeMy WebLinkAboutX2019-2134 - Permit Applicationprint Form Worksheet for Combo Building & Solar Permit Application
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r City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTgL
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OWNERSNAME Last SO rrrr
First a�.TT.. o�d.QYo.rt
Owners Address
i2 ki8kk0Aa pr,V� Owner's E-mail Address
57
Cm tierapbr e� e- State CA
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APPLICANrs NAME Last Ritdtart
First JaeOn
PPlicant's
04 Applicant's E-mail Address
JasonGriohartdesign. riat
r� Zip 92627 Telephone 949-422-9191 i
1 W. 18th St, (A106)
Costa Mesa State CA
NAME
LastlRichart
Architect/DesignersRddress
1041 W. 18th St, (A106)
City
Costa Mesa State CA
First Jason_.., Llc. No. �—
ArchttecBDasignefs E-mail Address
Jeson@dChartdeSign.net
Zip 92627 � Telephone 949-422-9191
ENGINEER'S NAME LastrAMIL � First BASHAR
Engineer's Address
751 SHASTA DRIVE
C�, CORONA, Cq State A
Lic. No.
Engineer's E-mail Address
ZiP�—I Telephone %�l,_Pjg3_i
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CONTRACTOR'S NAME/COMPANY _� �s (�7� I _ Lic. No. ?1j� '�'Z Class
ConVactor's Address Contractors E-mail Address
e(1. • Ga.>�,
city state zip Telephone
85(775-��1y�
SETBACKS REAR SETBACKS FRONT PERMIT NO. Jl� t� — -21
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SETBACKS LEFT _® SETBACKS RIGHT PLAN CHECK NO. � O
t)SE ZONE PLAN CHECK FEES $
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t_ DEVELOPMENT NO
Address
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