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HomeMy WebLinkAboutPV2019-008 - Permit Application'_ ��n€© Worksheet for Combo Building & Solar Permit Application o4��� City of Newport Beach - Building Division _ Comm'I ,' Residential NnTF- PI AN CHFCK FEES DUE AT TIME OF SUBMITTAL °4•=^"'� Building ❑ Grading [',Drainage ❑Elec CMech r, Plum cu Yd cut Cu Yd Fill C C Project Address (Not mailing address) C Flood ❑ Fire r Liq C Landslide [N/A Floor Suite No �)e'_Jo(k 6.3 Description of Work Use C Const Type # Stories # Units (if Res)�I 9 (a�lC � Valuations t— New/Add SF 1 �$ ; L( , iNemodel SF Garage/New/Add r^ Material/Labor (J �Q pts OWNER'S NAME Last �� ` eS P First `l n n �t I N Owner's Address Owner's E-mailAddress. qty i State .. Zip Z 6� 3 I Telephone APPLICANT'S NAME Last Y C Z (� Firsti Applicant's Address` - Applicant'sE-mail Address - $ao 1J G u o city G U. VLU. �L .State ([�� .Zip r � p— Telephone '9 -first ARCHITECT/DESIGNER'S NAME Last r C rti Lic. No. t(J���Z Jam' Architect/Designer's Address - Architect/Designees E-mail Address \\V Vr , 1<u - r to 'n Cinln 0Qy cyz�r '. City JU`k lAVj State .Zip TelephonerA� } ENGINEER'SNAME. Last First Lic.No.F_ Engineer's Address Engineer's E-mail Address City State! Zip Telephone CONTRACTOR'S NAME/COMPANY G��O Lic. No. \,o \ fZjZ--J` Class Contractors Address Contractor's E-mail Address ` City �(h __—l� Ij _ _ State `tom Zip I Telephone qZ �—�.l. t C4 ' .�f'»�... SETBACKS REAR SETBACKS FRONT f; PERMIT NO. \ V 010" iL �� ( SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT. NO PLAN CHECK FEES $ rd