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HomeMy WebLinkAboutX2019-1450 - Permit Application0,00- 1460 Print Form Worksheet for Combo Building & Solar Permit Application F_ Comm'I residential City of Newport Beach - Building Division r NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F�BuiIdiFig F— Grading F -Drainage rElec F`Mech F— Plum CuvdcutF— Cu Yd Fill F_ Project Address (Not mailing address) F_ Flood F•- Fire F" Liq F-` Landslide [_N/A Floor Suite No Description of Work Use Const Type Vfj. INi�2N�L �NIOD� L #Stories # Units (if Res)" Valuation $ Material/Labor O New/AddSFF_ Remodel SF11��, Garage/New/Add F_ OWNER'S NAME Last �%(I�JUI'�-. First qe�.-rr�\.' Owner's Address Owner's E-mail Address 3 MN12� I i to i} n ry.,'n oi� Mol CAP), WpyUf-I.- t✓�--. City V_pC, ftVtV-2-,. State Zipa; Telephone 99q G3�-9�rb APPLICANT'S NAME Last (ti f�L jf`�- First 0 \ Applicant's Ad-dlrreess Applicant's E-mail Address City1.� N� N� �� �e 1{. State C� Zip }� Telephone 7?q��- ARCHITECT/DESIGNER'S NAME Last First F Lic.No. F_ Architect/Designer's Address Architect/Designer's E-mail Address City State Zip Telephone�� ENGINEER'S NAME Last �2,,fJ/eC'%71�1' First j/1/f/�� Lic.No.Cr73Z� Engineer's Address Engineer's E-mail Address 3©© � rr 4, sr City C®Jr/Q- �t�1�C- State C� Zip �pZ� Telephone CONTRACTOR'S NAME//COLMPANYUl'�� �,),,,,, Lic.No. jOL)p'?p Class F6 Contractor's Address Contractoorr's E-mail Address _id-� a- -rvvL ovS c- d'� � c lz tv=i dear. C0C - rm C City Nt i�v-fly �j (gE7,c / f State Cdr, Zip �j� TelephoneF�(Gl _-.1?T oos S- I 10 � ., PERMIT NO. I - A J�yU SETBACKS REAR SETBACKS FRONT � ) _-0 AMI-A!9) SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. jn �) IL6'j USE ZONE DEVELOPMENT NO PLAN CHECK FEES $