HomeMy WebLinkAboutX2019-2445 - Permit ApplicationWorksheet for Combo Building & Solar�ermit Application
F_ Comm'1 j Residential City of Newport Beach -Building Division ; q
NOTE: PLAN CHECK FEES DUE AT TIME OF SURMITTAI
F -Building " Grading r -Drainage F-Elec (-Meth F-PlumCe Yd Cut CuYdrlll r�
Project Address) (Not mailing address) F Flood j- Fire f- Liq F` Landslide 7N/A Floor Suite No
Description of Work
Use Const Type
tk Storiesr R Units (if Res)r—!,.
\ r
New/Add SFr_ Remodel SF1___ Garage/New/Add r—!
Valuation
Material/Laa bor � � k
OWNER'S NAME -- Last e- --J Lel First
- Owner's Address
Owner's E-mail Address
A ,1
City r./r� f _ v State UL� Zip rr]� y0 Telephone—,
APPLICANT'S NAME' // / /
Last Il�4,SSo First
C--JL.-.9.f
Ap`plili-c7ant's Address Applicant's E-mail Address
City i elephone ""Ccv
State C� Zip %(�3T).'
(/yrf1f. l5��
�
ARCHITECT/DESIGNER'S NAME Last— First F � -
LicNo. F_
ArchitecUDesigner's Address Architect/Designer's E-mail Address
City F_ State F Zip Telephoner
ENGINEER'S NAME Las tFirst r Lic. No. �'. Y
�!,J
Engineer's Address Engineer's E-mail Address
1 L/
City l(/ _ State 'xj Zip L)::L.� i Telephpnef (/�!`t lc).'j 7- 1)`1�
U.
CONTRACTOR'S NAME/COMPANY Lic No. Class
Contractor's Address Contractor's E-mail Address
,,))
d,{'`ya �t�3 f`�=`r>�irJ.�n%� Fc -1, ..,�.-d r!/.,,..s=.,
City '�w� State (;i Zip ``e/1; Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. )��o Cq - Z q U
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 174J -,e,
USE ZONE .DEVELOPMENT NO. PLAN CHECK FEES $ -