HomeMy WebLinkAboutX2019-3429 - Permit Application (2)Print Form - Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) 17Flood r Fire r- Liq r Landslide [IN/A Floor Suite No
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Description of Work
Us Const Type (-{�
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# Stories Lo ] # Units (if Res)F_
Valuation $
Material/Labor '\
New/Add SFF4Ot.(E- Remodel SF Garage/New/Add I
OWNER'S NAME Last First -{
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Owner's AddressOwner's E-mail Address
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City FuT _-- State G{f_- -.... Zip o(] (o-I'�_ q
`Telephone
APPLICANPSNAME Last First[
Applicant's Address Applicant's E-mail Address
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City Neu►go�(-_ " State �iPc Zip °1266b Telephone j"-SO
ARCHITECT/DESIGIN�ER'S.NN�A,M� E t, i, - _. ,
OnC/' Whe INCh(1 &Ny& Last Prl)ho First (hY�%fjG Lic. No.
Architect/Designer's Address Architect/Designers E-mail Address
btUho@ohenin �tlotiii-. com
City �YV IY1�--------_ _ State Lot- Zip ` 2,6 ii �_-. _ Telep ne 1;62,- 113 - 4
ENGINEER'S NAME Last �9i � First IGen Lic. No.�
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Engineers Address Engineer's E-mail Address
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City Irvi1�8 - State Zip Telephone -
CONTRACTOR'S NAME/COMPANY Lic No. /� Class
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Contractor's Address Contractor's E-mail Address
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city IRV rNl_ State C� Zip 9ZC0 Z Telephone q_S(o2 -3/T7
SETBACKS REAR SETBACKS FRONT PERMIT NO. y
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. '
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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