HomeMy WebLinkAboutX2019-3818 - Permit ApplicationPrint Fo m ` Worksheet for Combo Building & Solar Permit Application
F] Comm'I [i Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[-_,Building ['Grading [Drainage [-Elec F.Mech [I Plum
CuvdCut �i
cuYdFill F7
Project Address (Not mailing address) ❑ Flood ❑ Fire F-,
Liq ❑ Landslide
❑N/A�Fl000rr
Suite No
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of Work Use F— ConstType L-11
1
S 'POUF 0 CLI- ozl P i � I
IStories�i #Units (if Res)
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Valuation $ .V
New/Add SF —'I Remodel SF7 Garage/New/Add Material/Labor
OWNER'S NAME Last
Owner's Address
Owners E-mail Address
City State Zip 1-2Lc(e(') Telephone�t}Q'��'�
APPLICANT'S NAME Last
Applicant's Address
_� �_C-/�
city _� � �;� State
First ) -�JirJ LJ C
Applicant's E-mail Address
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last i First Lic. No.
S fn > C7 �_- �El------
Architect/Designer's Address
City SA- �T{Jv C-13I7�9� State
Architect/Designer's E-mail Address
ScC57T-
Zip!, Telephoned
ENGINEER'S NAME
Last .���1 �(Y'\ - _ � First ' ��� __. Lic. No. C75 5Ink., 1�
Engineer's Address
Do 0
City \O V 1 T _ _-_ State 5
E-mail Address
Zip �, Telephone F CL t _a %KC)dd
CONTRACTOR'S NAME/COMPANY t C L�-�C.--1 Lic. No. � Class FY;
Contractor's Address
City `LV C_� i ,I State
SETBACKS REAR
SETBACKS FRONT
Contractor's E-mail Address
Zip Telephone NOreS/ - ? CL! ,
PERMIT NO.
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PLAN CHECK NO jtI L
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PLAN CHECK FEES $