HomeMy WebLinkAboutX2019-0557 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I F- Residential
NOTE:
City of Newport Beach - Building Division
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding F -Grading rDrainage F_Elec FMech F— Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood r• Fire r Liq F_ Landslide CN/A Floor Suite No
-
F_-'
F
1.5 _
Description of Work
Use F—ConstType F
# Stories # Units (if Res)F—
valuation S
Material/Labor q 1i 0 0
New/Add SFF— Remodel SF1— Garage/New/Add F —
OWNER'S NAME Last {Vt..WP0rL CsttSsr _ First
Owner's Address Owner's E-mail Address
-r.01 T:N—a IA=fit A Sr
city . N vi, state F 4Zipiq 63 Telephone '9 444 611 017.5'
APPLICANTS NAME Last SMS First hoje v5'
Applicants Address Applicant's E-mail Address
1} 3 42 CA IV tot u K/ i --t
city-. 5'.I �A.IV': �i _ . ,N.� _ _ State C4_ ZipFrTL,% OS Telephone 71 (r S -S g (1 4
ARCHITECT/DESIGNER'S NAME Last First I Lic. No. 7—
Architect/Designer's Address Architect/Designees E-mail Address
_- __ -- _ .. ___. _
City �— State F— Zip Telephonel
ENGINEER'S NAME Last ( ri 0 First Q (0 — Lic. NoT—
Engineer's Address Engineer's E-mail Address
15`x. D i3a0og, %4 mLn w
State �— Zip �7 Telephone % /4. 661 OS -10
OS
City . SNUT li AIV (§
CONTRACTOR'S NAME/COMPANY Lic. No.76.1-744,9 Class 1
NG tJ S tw %,rl-k Co NST
Contractor's Address Contractor's E-mail Address
Lynn-t/o�ry
p
City .. NT _ _1y11/ �- State �— zip _q ill i 05 Telephone) ? I 3 O
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. XUI"t •
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $