HomeMy WebLinkAboutX2019-1722 - Permit ApplicationPrintFom Worksheet for Combo Building & Solar Permit Application o4�" °re
F_ Comm'I r - Residentia City of Newport Beach - Building Division ;
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G,.�a�'
F`Buildipg ring ag `Plum CuvdCutF_ Cu Yd Fill
In
Proje dress (Not
WF_4ch2
mailea ad r d F Fire ( Liq Landslide I -N/A Floor Suite No
GA�l_ ��{ 7�'�i' � c/1F I
1 81�41�
�1xa?�� w
- t
Description of Work
UseFV ConstTyper
#Stories #Units (if Res)
Valuation $ i
Material/Labor
New/Add SFF—
Remodel SFF_ Garage/New/Add ��
OWNER'S NAME
Last a First
Owner's Address
Owner's E-mail Address ..��/g�.
(
10I�Lq%911/
City 1�` �'' -. _..
State Zip — Tele\p.+h"one M'31 1
APPLICANT'S NAME
Last L� I First AA1 10
Applicants Address
AApplicant'sEE-mailAddress
g�g'
city ���� �'�
State [CA Zip j26, Telephone 9671 Lj
ARCHITECT/DESIGNER'S NAME Last First F Lic. No. I
Architect/Designer's Address
Architect/Designer's E-mail Address
City _
State rZip -: Telephone
ENGINEER'S NAME
ke
Last�j y� First !'Y'� LicNo.'..
1
!4 \
Engineer's Address
Engineer's E-mail Add ss e
City
State F_ Zip Telephone
CONTRACTOR'S NAME/COMPANY 6,Ik�ic. No.Class (2,
Contractor's Address
Contractor's E-mail Address
x.
cc rn
City l
State I 0i Zip 2 ) Telephone 4 B t 4
REAR
(E:BI(K LEFT
SETBACKS FRONT PERMIT NO.
SETBACKSRIGHT PLANCHECKNO.
DEVELOPMENTNO PLAN CHECK FEES$