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HomeMy WebLinkAboutX2019-0197 - Permit Applicationan -isq (k Worksheet for Combo Building & Solar Permit Application Comm'I j residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building i Grading F-Drainage FElec Mech j—Plum CuvdCut cuvdFill irojeet Address (Not mailing address) [ Flood F— Fire r Liq J— Landslide CN/A Floor Suite No lescription of Work Use d Const Type 12.1 I • ' a �`' Stories # Units (if Res)s Sr, s'Crnr Selz. " Valuation $ ? ,t,q" New/Add SF I Remodel SF 12 Garage/New/Add I Material/Labor; rl _Ol v � v OWNER'S NAME Last ASu - First, Owner's Address Owner's E-mail Address 1149 SAO^. /rt� City yJ"', C.do-t State F C ,{,t Zip Telephone N APPLICANT'S NAME Last ��'�ist,�.�� First Applicant's Address 112.5 i City L✓"�!r. State CIA NAME Last Applicant's E-mail Address Zip Ij Qg'l Telephone �(o2._%3 First Lic. No. F_ ArchitecUDesignefs Address Architect/Designer's E-mail Address r'r-lq- city I State ! Zip d— Telephonei � ENGINEER'S NAME Lash 1�►�►s�� First lS C.,C� Lic. No.��'� 5 Engineers iAddress Engineers E-mail Address ` r City State— Zip i, j Telephone) 11 =S — IUJ�T LA^ o.. Lic. No. ��/ Class" CONTRACTOR'S NAME/COMPANY —' 'S-7 Contractor's Address J/ Contractor's E-mail Address 11 \� City6Si�Sr� Stater ZiP' 9c��ro Telephone SETBACKS REAR SETBACKS FRONT SETBACKS LEFT — SETBACKS RIGHT _ USE ZONE PC- SS 2 DEVELOPMENT NO PERMIT NO. /\w` l' PLAN CHECK NO. 1IN -lip ISLAN CH€CK F€ES