HomeMy WebLinkAboutX2019-2722 - Permit Application (2)- K 20 I q-2722_ Z-bd U Marc{ V -d
Pint Form Worksheet for Combo Building & Solar Permit Application
[X Comm'I (— Residential City of Newport Beach - Buildin DI ' '
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jX Building [Grading rDrainage f— Elec
Project Address (Not
300 Ford Rd
F Mech
F Flood
r PIUm Cu Yd Cut Cu Yd Fill l
F_ Fire [" Liq T_ Landslide j N/A Floor
F
Suite No
se A, B Const Type V-A spr
Stories # Units (if Res)[_
New/Add SFI Remodel SFF� (Valuation $
Garage/New/Add Material/Lal
OWNER'S NAME
Owner's Address
Last I
City _State F_—.. I_
Zip
APPLICANT'S NAME Last
Address
0
TelephoneF �
Applicant's Address First (John / Robinson Hill Architecture
- -
3195-B Airport Loop Dr Applicant's E-mail Address
hill@rhainc.net
City Costa Mesa StateCA —
Zip 92626 Telephone 714.825.8888
ARCHITECT/DESIGNER'S NAME
Last Same First
Architect/Designer's Address - Lic. No. F�
Architect/Designer's E-mail Address
City State rZip 1� Tel
_.
ENGINEER'S NAME Last
Engineer's Address
City State F—
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State F_
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
a ephone�._._
First I_ Lic. No.F �
Engineer's E-mail Address
Zip [, TelephoneF�..
Lic. No. F� Class F_
Contractor's E-mail Address
Zip[,� TelephoneF�
PERMIT NO. j(U(j J.7U-1 L?L3
PLAN CHECK NO. I
PLAN CHECK FEES $