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HomeMy WebLinkAboutX2019-0052 - Permit Application (2)Prjnt Form Worksheet for Combo Building & Solar Permit Application o4 6w°�a r- Comm'I r Residential City of Newport Beach - Building Division �? a-0052 a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL ❑<..oa+" rBuilding f7Gradingr-;Drainage j—Elec r-Mech r; Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r- Liq rLandslide FN/A Floor Suite No clO(, A-V©Cilivva A -057F. bescription of Work ON 5 I LCD ' I U g M i Al%Q- Use Const Type F # Stories #Units (if Res) Valuation $ i [llZOo °$ ' Material/Labor —, New/Add SF Remodel SF Garage/New/Add OWNER'S NAME (pal/\ElZGiR�- CjJK{ ERS ;PNL, �G$T Owner's Address Owner's E-mail Address 53!02. t�oLS�► /} Gly Su�TE C City ffilq'r( '', State (�fl • ZiP 9��q Telephon %ly 5 4—S APPLICANT'S NAME. ✓� FaRi Applicant's Address Applicant's E-mail Address 73 ( Noj� 9A -1k 5�7_- JA -146 (O/J r�7.D,60114 City �1��'6`b�E State �—� g6 Zip �zTelephone /L�. 2.31—$Z47-3 ARCHITECT/DESIGNER'S NAME �M R Lic No.W" Architect/Designer's Address ArchitectIDesigner's E-mail Address City _ State F Zip FI Telephone—; FgoF C)WaEtp`S N4n4S.' T d i F V I N E; C0XT A -c I" CONT/4e-7-: AXON FR � ASis 3rd tj AG A gri®2(zATr�l�) ilo InlNo ✓AMON -�P7z1Va �y City I iP✓[tg6 State M ZiP q'Z(rJP7 -,,, Telr'phone ?4 !ZO•— 0o CONTRACTOR'S NAME/COMPANYy Ru�MA RK j KC dR �� ti Lic. No. Class 8� 7` Contractor's Address Contractor's E-mail Address 751_ N001 W w QiJ iio C,M City - �G State FP7 Zip R`%,,,2 Telephony 7/g),2,3/-5�cr 3 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. •yie� USE ZONE DEVELOPMENT NO PLAN CHECK FEES $