HomeMy WebLinkAboutX2019-1897 - Permit ApplicationPrint Form 1 Worksheet for Combo Building & Solar Permit Application
r✓ Comm'I r" Residential City of Newport Beach - Building Division(� �i` l �-
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
71BuIIdIng FGrading j Drainage rElec F_Mech Plum Cu ydCut F_ CuvdFill F_
Project Address (Not mailing address) I_ Flood j Fire F_ Liq F_ Landslide FN/A Floor Suite No
35-7 54M ^qm ( A-4, F_ F�;_
Description of Work
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7y st P
Lcu' \ #Stories #Units (if Res)
V\_
New/Add SFF— —Valuation $
Remodel SF— Garage/New/Add Material/Labor
OWNER'S NAME LastA' �eu�✓ N Ahyawr~ f (aw�ywirst G�
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Owner's Address
Owner's E-mail Address
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City �t��o.� I3ta k� State Ci}
Zip F12660 TelephoneF_�
APPLICANT'S NAME
Last �f.,,�de> _ First 1
Applicant's Address Applicant's E-mail Address
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City ){^^fi441• PrA.M State C(A ZIP gi2b4$ Telephone (W)r$• SV 5ry
ARCHITECT SIGNER'F�t
+�� First
ILJQ_ `/ -j Lic. No. �
Architect/De ' ress rchitect/Designer's E-mail Address
i
City (-.---- State F— ZiP�— TelephoneF_�
ENGINEER'S NAME Last First
LicNo.��
Engineer's Address Engineer's E-mail Address
City [ State F_ /
CONTRACTOR'SNAME/COMPANY sib C�vicehj�
Contractor's Address
wa/ 6041-1rd
City Inc �'^S
SETBACKS REAR
SETBACKS LEFT
USE ZONE
ZIP Telef
Contractor's E-mail
State Cao Zip j .9264 K
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Lic. No. 517- J Class �,tj
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PERMIT NO, X'7,0 Iq - I U cj 7
PLAN CHECK NO.y5? 3 — z 0 iM,
PLAN CHECK FEES $ Z- Or , q 7