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HomeMy WebLinkAboutX2019-3662 - Permit ApplicationPant Form Worksheet for Combo Building & Solar Permit Application o�Re Comm'I Residential City of Newport Beach - Building Division ``-- NOTE: PAN CHEC .FEES DUE AT TIME OF SUBMITTAL uilding ❑ Grading F.-Drainage Elec ,r° FMech ❑ Plum cuYdCut � cuYdFill Project Address (Not mailing address) ❑ ❑ s jj Liq ( N/A Flood Fire Landslide ❑ Floor Suite No L9,13 E C,AI BCa, B L v o ._7 F-71 Description of Work l( �)6 1 Use � Const Type I - . # Stories # U ' s (if Res) ✓j New/Add SF Remodel SF Garage/New/Add Valuation $ �] Material/Lab OWNER'S NAME Last First blx Owner's Address Owner's E-mail Address ?o 9 r_ . &16© (4 Q (W � 6 cam , City a y� State l!� Zip Q 2 (p tf� Telephone �� 3 . 9 IAPPLICANT'S NAME Last` First MASS 12 —_ Applicant's Address 691 F '`u 5-T City State Applicant's E-mail Address Zip ck2- yo I Telephone 1�. � Z 3 ARCHITECT/DESIGNER'S NAME Last First A, Lic. No. Architect/Designer's Address t 6 6 l —r— 71--1 -ig- 7. City I 5 Wl" State Arch itect/Designer's E-mail Address Sat4-Q_ m Zip 'A2!7o' Telephone '�`t� ENGINEER'S NAME Last S`AL E/h I First �A ,� 2 5�-( � Lic. No. Engineer's Address City N _� State Engineer's E-mail Address Zip c� 2 of Telephone Jy/ 1 / /- CONTRACTOR'S NAME/COMPANY i Lic. No. �� Class Contractor's Address I City - - --- --- - - -- State SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO Contractor's E-mail Address Zip Telephones—� PERMIT NO. > V-9' - Z)UL4 PLAN CHECK NO. PLAN CHECK FEES $