HomeMy WebLinkAboutPV2019-121 - Permit ApplicationYr M Tm Worksheet for Combo Building ding &Solar Permit Application
F Comm'I I� Residential City of Newport Beach- Building Division PV,?Ol9- 191
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL of
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Description of /Work �
Yirn.rwCc Use
dll� / t �L 7 % / / 2 .la Const Type 5o/cvr
EX` 51 n 5 400MM? ma,ti,, n # StonesT # Units (if Res)
New/Add SFT Remodel SF r �_
( Garage/New/Add �� Valuation $
Material/LaborSq, oC90
OWNER'S NAME
Last I l
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Owner's Address -- -- First �e l _.
$-7 D .7G��ttk1f Owner's E-mail Address
City�� p p
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APPLICANT'S NAME
Last �'`
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Applicant's Address "Al
GYM 3 �.,r _ Applicant's E-mail Address
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`RS7A. State
ZIP 9Z(aZ% Telephone L)r{fl 3Z(e'31G2
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address First'
Lic. No.
Architect/Designer's E-mail Address
City.._
State
F`
Zip
j Telephonel�`' I
ENGINEER'S NAME
Last �--�-W--�--,____
l'Lt4.et1✓xq First ----.-
Engineers Address JJ Lic No.rC(ay/
-_ Engineer's E-mail Address
L7 / C;9k+1',o"gtLiN 2
city �t
State/�
Cp ZPI (2�oy(p Telephone��c( 1 ~� y
9 285-5/O
CONTRACTOR'S NAME/COMPANY
V 1 ��CArf Lic No.
Contractor's Address 029207 Class cnfa
Contractor's E-mail Address
C6S� l�'lt,jp„ _. State G�} ZiP)x)24 7 p
Z Tele hone(g08 gV„3g33
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT ��
USE ZONE DEVELOPMENT NO ��I7/.-( l-j�Ga
PERMIT NO. '{ "01 r { wkt
PLAN CHECK NO.
PLAN CHECK FEES $