HomeMy WebLinkAboutX2019-3201 - Permit Application (2)k mpl • 32�1
Worksheet for Combo Building & Solar Permit Application
❑ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB]
_Building ❑ Grading ❑Drainage ❑Elec ❑Mech ❑ Plum cu Yd cut cu Yd Fill 1 171
Address (Not mailing address) ❑ Flood
❑ Fire
❑ Liq
❑ Landslide
❑N/A Floor
Suite No
°") / rJ, rid''
__-
# q
7
F
Description of Work
'ExTe,a''o Govt to 14& cTik f e3 Ex re rr. c %�L rv/Ad!
New/Add SF Remodel Garage/New/Add �fd
OWNER'SNAME Last
Owner's Address
�IoDo Cep --i
City I fin State A ]
APPLICANT'S NAME Last
Applicant's Address
City State
Owner's E-mail Address
Zip
First
Use = Const Type =
# Stories # Units (if Res)
Valuation $
Material/Labor.
Applicant's E-mail Address
Zip Telephoned
ARCHITECT/DESIGNER'S NAME Last I— i First Lic. No.
Architect/Designer's Address
City 1 State
Architect/Designees E-mail Address
]
i
Zip Telephoned
ENGINEER'S NAME Last �J w N C First L Lic. No.F_
Engineer's Address
City State
Engineer's E-mail Address
I
Zip TelephoneF_
CONTRACTOR'S NAMEKOMPANY Lic. No. Class 03 (E7
eWove NSrr�c—ti�tiscl
Contractor's Address
CaS�N — � -r�r• IN v�
City I `–a 7 Ikl S %4-_ State �',i
Contractor's E-mail Address 70 /6j
Zip ��, a Telephone
SETBACKS REAR /r�) , SETBACKS FRONT G0 , PERMIT NO. Xdn I� -ajz10
SETBACKS LEFT Q, SETBACKS RIGHT PLAN CHECK NO. (30111
USE ZONE 12, Q DEVELOPMENT NO PLAN CHECK FEES $
(052 1