HomeMy WebLinkAboutPV2019-195 - Permit ApplicationPrint Forn Worksheet for Combo Building & Solar Permit Applicationo �WPo
❑ Comm'I Residential . City of Newport Beach - Building Division
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❑Building ❑Grading []Drainage ❑Elec ❑Meeh ❑Plum CuvdCut Cu yd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
Description of Work
Use = Const Type C /
Z�s
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# Stories # Units (if Res)❑
Valuation $
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New/Add SF Remodel SF�I4rage/New/Add
2 Z ZMaterial/Labor
OWNER'S NAME Last /
First
Owner's Address '.
145 &dqcazi:�
Owner's E-mail Address
CityE State i—WJZIPr�J��,�,
L-� Telephone�"_
APPLICANT'S NAME Last6A A
First �LP
Applicant's Address
Applicant's E-mail Address Li
11
141&4 F&V 5'(07c
City Ixvviyc State I �/[l 1
Zip z telephoneJf-
ARCHITECT/DESIGNER'S NAME Last First Lic: No.
ArchitectIDesigner's Address
Architect/Designer's E-mail Address
City I I State
Zip � Telephone
ENGINEER'S NAME Last
First Lic. No.�-�
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephoned
CONTRACTOR'S NAMEBCOMPANY l rn
I Lic. No. Class OV
Contractor's Address
Contractor's E-mail Address
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� C Ct • GIN(
City C Vly '� ...State .Zip
` ephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK No. 04
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $