HomeMy WebLinkAboutX2019-2419 - Permit ApplicationPrint Form_ Worksheet for Combo Building & Solar Permit Application S
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME riF sl rannlrrni
IX —Building FGrading F-Drainage F-Elec FMech F-Plum Cu vd Cut l Cu Yd Filll
Project Address (Not mailing address) r Flood r Fire iq 1— Landslide f N/A Floor Suite No
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DeaBcrlption of Work
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Stories #Units (if Res)r—
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Valuation $
Material/Labor OM
New/Add SF F— Remodel SF
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Garage/New/Add �!
OWNER'S NAME Last r w
First /u0,y—C ICL
Owner's Address
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Owner's E-mail Address
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City N' State CA Zip F— Telephone) —
APPLICANT'S NAME Last Richart
First Jason
Applicant's Address
Applicant's E-mail Address
1041 W. 18th St, (A106)
Jason@dchartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 949-422-9191
ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. �-
Architect/Designees Address
ArchitecttDesigners E-mail Address
1041 W. 18th St, (A106)
Jason@dchartdesign.net
City Costa Mesa State CA
Zip 92627 Telephone 949-422-9191
ENGINEER'S NAME Last JAMIL
First Bashar Lic. No. CR)12-9
Engineer's Address
Engineers E-mail Address
751 SHASTA DRIVE
—
City CORONA, CA State A
Zl p r-i Telephoner ---
CONTRACTOR'S NAME/COMPANY
Lic. No. rClass r-
Contractors Address
Contractors E-mail Address
City F— State r`—
Zip F_ TelephoneF_
SETBACKS REAR SETBACKS FRONT
PERMIT NO. d1 `tpLA b
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
15-1s. O"t