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X2019-3812 - Permit Application
Print Form _^ Workshoot for Combo Building 8, Solar Permit Application Comm'I [J Residential City of Newport Beach - Building Division f!, NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building ❑ Grading FDrainage �I Elec n Mech C Plum Cu Yd Cut Cu Yd Fill F-1 'roject Address (Not mailing address) ❑ Flood [1 Fire ❑ Liq [i LanLLdslide ❑N/A Floor Suite No Description of Work cv 4�u✓ S t.. � p } ,� Z, p �a �. New/Add SF 1 a Remodel SF 1 Garage/New/Add - Use Const Type V # Stories ? 1 # Units (if Res) Valuation $ y 00 Material/Labor OWNER'S NAME Last ¢ �,t� First rL1'." l Owner's Address Owner's E-mail Address '? -zr-> 2 V 15 r n. C�,®1✓ L�ty� &,NA 4�z L . Z0 r City fJ r,.w P ViL T State �— t-w Zip Telephone I APPLICANT'S NAME Last �� I First l ril Applicant's Address Applicant's E-mail Address LL% , City qa g,C3i0 C �,.m State Zip Tele hon ewa�;�-1 ARCHITECT/DESIGNER'S NAME Last First '�►,n. E PPL i tom,, Lic. No. —� Architect/Designer's Address Architect/Designer's E-mail Address city _ State Zip 7 Telephone ENGINEER'S NAME Last Y _i First t Lic. No. Engineer's Address Engineer's E-mail Address 2b tt_� w�ST c, r -02 c�V1- i r n C City � I-,^ H 4.A^� State C .© Zip t��Zj(Telephone '71 y Z afo CONTRACTOR'S NAME/COMPANY I —moo d -$ Lic. No. ;, Class Contractor's Address Contractor's E-mail Address City State ZiP �' Telephone xi -- � ?,. D P SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT PERMIT NO. \s5r(J _I — PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $