HomeMy WebLinkAboutX2019-0552 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application010WO
Comm'I Residential City of Newport Beach - Building Division
r r NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r- Grading F -Drainage r-Elec (-Meth F' Plum C.Yd C.tl Cu Yd Fill F
Project Address (Not mailing. address) (— Flood f— Fire [— Liq r Landslide I -N/A Floor Suite No
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t -
Description of Work
Use Const Type
# Stories ' #Units (if Res)
Valuation 5
-
New/AddSF�— Remodel SF Garage/New/Add—'
Material/Labor 9 1'400
OWNER'S NAME Last �N��Wf�Oft Lf „tys T' First
Owner's Address : - Owners E-mail Address
City N ... _ _ State - Zip 41 6 6 Telephone 9 W 631 0 111 s
APPLICANTS NAME Last c `.� t.� First gjC
Applicants Address Applicant'sE-mail Address
14�,R-
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City .... hS (1ty 1114 -1114 -State ( Zip C,i'1 �S Telephone 7 1 S 3 CD I I (�
ARCHITECT/DESIGNER'S NAME Last First— Lic. No. �—
Architect/Designer's Address ArchitecNDesigner's E-mail Address
City �— .; r State. Zip F Telephone -
ENGINEER'S NAMELast X 0 First Q (AIv6, Lic. No. S�� -sot
Engineer's Address Engineer's E-mail Address
1S -;Iv (3Ro oy[ X vu.nw %Z�4s-
City ut'
&A -R . Ati(t- State Zip. g' TelephoneF7 i4 G61 dslo
CONTRACTOR'S NAM E/COMPANYSr�.-c�+ r Lic. No. F— Glass r—
N�.us !.� u s
Contractor's Address Contractor's E-mail Address
City State Zip Telephone�—
S n� N��27 oS i ; 14 S 3g 1 41
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. x U11 "X"
PLAN CHECK NO.
PLAN CHECK FEES $