HomeMy WebLinkAboutX2019-1954 - Permit Application01l IN
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
j Comm'[ j Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r"Building I Grading (-Drainage j— Elec Mech j Plum Cu Yd Cut�Cu Yd Fill
Project Address (Not mailing address) f- Flood F_ Fire r" Liq (- Landslide N/A Floor Suite N
f -
Description of Work
Use Const Type F
# Stories! _#Units (if Res)
'J_ 3 7
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Valuation
Material/Labor V
Garage/New/Add
New/Add SF { Remodel SF 1
OWNER'S NAME Last � First! ( emu 2
Owner's Address Owner's E-mail Address
City I NeWpbp-7- 5q/4+vl State Zip I /2 Telephonell
APPLICANT'S NAME Last; First lL llMf04AO
Applicant's Address Applicant's E-mail Address
City State �— Zip I Telephone
ARCHITECT/DESIGNER'S NAME Last First I Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State — "Zip Telephone)
i
ENGINEER'S NAME Last! N�(Z-i ( p(C-� First 1, Lic. No.1�t�(p Z%Zl
cJ
(Z4N�
Engineers Address Engineer's E-mail Address
f
City I (� State I Zip ; Telephone 7 1
CONTRACTOR'S NAME/COMPANY Lic. No. 16 14tH 0 Class
itr-lc OLAA/05
Contractor's Address Contractor's E-mail Address
(8 30 iyo ti 11 r Am_ si-m , � SD ,Jcf Fo ree—AVuw PZ, Ptr\rra^S . 4-"�.
� 1
City ! ( r2wi (/f� - - State �— Zip i q M IL Telephone�� -�-I Z- 2j� �(�
SETBACKS REAR SETBACKS FRONT PERMIT NO. l !/✓
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SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1
1 1 IQ= 7t-HUG n=1=I normCr Ir rli) PI AN CHECK FEES