HomeMy WebLinkAboutX2019-0527 - Permit ApplicationWorksheet for CombaBuilding & S�61 r Permit Application
r- Comm'I Residential City of Newporf�each - Building ivision
NOTE' PLAN CHECK FEED DUE AT TIMEIF SUBMITTAL
Building r Grading Drainage F/Elec F✓Mech
jrPlum cu rd cutr� Cu Vd Fill
Project Address (Not "ling address) F- Flood
ire r Liq F— Landslide I N/A Floor Suite No
73$ 'I6iSfii�L �v'�. Sltf}e 4A t
9,eacti, CA, 9
Description of Work
' r—
Use j Const Type l v—l`3
�csrtny, dw•• �Y hww,� 10 /rrn� i)L.4f -f<]e -iife
# Storiesi Q #Units (if Res)r—
Valuation$ oO �^
Material/Labor t �
j DAo�� ,;�r�ruir -4h� Ge1:v�S.Qr�1 �uls�mb„�-
New/Add SF � Remodel SF _ Garage/New/Add �— —
2—
OWNER'S NAME Last Y,41V C
First ku r l— it
Owner's Address
Owner's E-mail Address
173 Tck-�skv fUz . S+a, t` A,
--
City !jt0/} 13:41 State C�
Zip g a Telephones' 4C7t{_y�i
APPLICANT'S NAME Last.
First l ftU 1VV^.'(
Applicant's Address
Applicant's E-mail Address
j 152a Gfr kvo6o pt�de ate S
! r-k,,V ZZQ(XjKe�•cc ch
City 1� ti Jq State Ct"'
Zip 9`17vh Telhephone1 "T% O
ARCHITECT/DESIGNER'S NAME Last f (�CJylt
First F Aa4:k Lic. No. /Jl(�
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
_
I l� 06ule --vAr �'
AF6 e ccra�
City � �� State! CA
Zip 59i7o6TelephoneFj142_ ��7G
ENGINEER'S NAME Last —_--First
F—
FirstF— LicNo.F—
Engineer's Address
Engineer's E-mail Address
_
City i , State j
I
Zip F— Telephonej
CONTRACTOR'S NAME/COMPANY
Lic No. j O'3 270 Class r3
Contractor's Address
Contractor's E-mail Address
k)C4, Pr.
5-1pix�ta,1.La ti
city �I�Qy�;�,yt State/'ll
9
Zip�Lz��.� Telephonel`[�a�__�ZQp�%
SETBACKS REAR SETBACKS FRONT
PERMIT NO -Cj SZ�
SETBACKS
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $