HomeMy WebLinkAboutX2019-3727 - Permit ApplicationKU10l-312V-
°Print,Fai,,, Worksheet for Combo Building &Solar Permit Application
E7 Comm'I E] Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
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Description of Workt( Use F7 Const Type
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# Stories #Units (if Res)F7
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Valuation $
New/Add SFE77-7— Remodel SFJ Garage/New/Add �� Material/Lab,
OWNER'S NAME Last First i -Si
Owner's Address Owner's E-mail Address
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City 7 State Zip Telephone 31.G7i
APPLICANT'S NAME Last First
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Applicant's Address Applicant's E-mail Address
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City ®VGI, State Zip Fj�6 Telephon��S
ARCHITECT/DESIGNER'S NAME
�,�—� Last First )zd Lic. No.
ArchitecUDesigner's Address Architect/Designer's E-mail Address
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City ..� �_ State ® Zip I C !'7 S4 I Telephone i;i ,C
ENGINEER'S NAME Last 441 it 151sT First M¢ S Lic. No.
Engineer's Address Engineer's E-mail Address
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city State Zip 70,11 Telephone
5� �1416_1 1 5 273j
CONTRACTOR'S NAME/COMPANY I((� e(jy it[cz� c, Lic. No. Class
Contractor's Address ° , Contractor's E-mail Address
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City m_ p�.�afp ( (. ,r�� State � Zip �` i-� .c� Telephone6:(767 ,,6./ a
( S 7 72
SETBACKS REAR SETBACKS FRONT PERMIT NO. J!�2 , ,?7 / -
SETBACKS LEFT SETBACKS RIGHT—y�. PLAN CHECK NO.�
USE ZONE DEVELOPMENT NO ��,�'� 17 =LL 3 PLAN CHECK FEES $
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