HomeMy WebLinkAboutX2019-3612 - Permit ApplicationWPp
Print For Worksheet for Combo Building & Solar Permit Application oe
City of Newport Beach - Building Division (q Z
I— Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building rGrading rDrainage rElec rMech Plum Cu vd cut Cu Yd Fill
Project Address (Not mailing
address) I- Flood ( Fire (— Liq Landslide FN/A Floor Suite No
Description of Work
Use Const Type �;n
it Stories # Units (if Res)
n
Valuation$
Material/Labor K C )�
New/Add SF ��� Remodel SF .'wy C v Garage/New/Add F_
OWNER'S NAME Last
First L R 1
Owner's Address
Owner's E-mail Address
CA f �/
City
—
State—, Zip Telephoned
APPLICANT'S NAME Last
S 1 SS O rti First
Applicant's Address
Applicant's E-mail Address
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State �— Zip Cl Telephone qI G Go,C) %�1 S
ARCHITECT/DESIGNER'S NAME
Last "p,) First Y1k-jn Lic. No. F_
Architect/Designer's Address
Architect/Designer's E-mail Address
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City �—
State FZip �� Telephone
ENGINEER'S NAME Last
First FTTP, Lic No f
Engineer's Address -
Engineer's E-mail Address
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City '�5
State CVc Zip r Telephone s �u — 3L`L'—SLif
CONTRACTOR'S NAME/COMPANY
Rq7L �t \t�25 S � Lic. No. ic�6G`1 �t Class
Contractor's Address
Contractor's E-mail Address
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City w
State Zip Telephone qqq
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. l8vii� �I
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $