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HomeMy WebLinkAboutX2019-2930 - Permit ApplicationC Sign/ ��P/M717-> X20�C1- 2.9 30 RrinE Foem Worksheet for Combo Building & Solar Permit Application ����"° F' Comm'1 r Residential City of Newport Beach - Building Division a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5<�.�.�" F713uilding F- Grading rDrainage rElec rMech F-PlumcuydcutF Cu Yd Fill Project Address (Not mailing address) f ' Flood r Fire j Liq r Landslide FNMA Floor Suite No rl 0©16 Q ' CEA)T �- Description ofWork Vrj E ) .. � E — I- �`u„�L lq A'j�d . Use F Const Type / 60 L �.r !04w� ry� W/��('I!!;'a #Stories #Units (if Res) 966 5 CARE I,' li l s S 19 N Is BEI 49 Valuation $ NST,#a—c( W C�ZG E GT. J05.6ph i� -rt1Material/Labor tl OWNER'S NAME—%_ IRVjtAG CoMf>ikA (20 r6a7. RSA j i -<L YO"M Owner's Address 6zAo N6vi pozr CeoToik' �, 15-o City ti EW Q �L`Li'Ll{ _ State ..Ct' Zip p 7 .6 Telephone x,29 -.i4 sa APPLICANT'S NAME.])/} -VE ,'RAI/ XO.Q'i /0j / Applicant's Address Applicant's E-mail Address 7 3/ NneM 14AI A 5r GSA v� (9 4" - - ......... City m �q'E _ State Cf} Zip gyg(og Telephon 7/4L,z 31- Bz d?3 ARCHITECT/DESIGNER'S NAME Last \Al ( t�s �' First Siti" Lic. No. Architect/Designees Address-" (,i. ,vi Q.{� [I JAG ArchitecUDesigner's E-mail Address City - State —'.. Zip F Telephone ENGINEER'S NAME t l/jL Last First ; Lic. No.F IV ri Engineer's Address Engineer's E-mail Address City � State Zip F_; Telephoned— CONTRACTOR'SNAME/COMPANY (zUEMf�i� �/�G�ibif) (/B3D,/.^Lic.No. Class 4d $ Contractor's Address Contractor's E-mail Address 73/ aonv�� rJa3D , emH, City State Zip Telephone /4 Z3/�,pv7,r mR"e ( cit- gz (w (� SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. " USE ZONE DEVELOPMENT NO PLAN CHECK FEES $