HomeMy WebLinkAboutPV2019-180 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Perm�ipt, Application
F- Comm'I r Residential City of Newport Beach - Building Division T V
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) C Flood r Fir L r Landslide rN/A Floor Suite No
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Description of Work ��1Ts%
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New/Add SF 3 L� Remodel SFF Garage/New/Add �',
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OWNER'S NAME Last Mr1IQ� First �� l
Owner's Address Owner's E-mail Address
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City State F_Zip F Telephone 7rLI , C/aQ,71 f O
APPLICANT'S NAME Last F First ZacGk
Applicant's Address Applicant's E-mail
lAddress
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City State Zip Telephone Ira aRVi�
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. r
Architect/Designer's Address Architect/Designer's E-mail Address
city State r Zip �I Telephonel
ENGINEER'S NAME LastFirst Lic. No. 6?6Gj.
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Address J Engineer's E-mail Address
EI_ngineer's
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City StateGA Zip qa��7 . Telephone 70,G30.61DO
CONTRACTOR'S NAME/COMPANY Lic. No. 7LIC130 Class
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Contractors Address Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. V l Wu
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. J ''
US6 °ONE DEVELOPMENT NO PLAN CHECK FEES $