HomeMy WebLinkAboutX2019-3941 - Permit Application`Print Form Worksheet for Combo Building &Solar Permit Application oF, °�>a
Comm'I Residential City of Newport Beach - Building Division of
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `.e
Ouilding FI Grading ❑Drainage F_. Elec (—Meth ❑ Plum CuYdCut e, cuYdFill 177
Project Address (Not mailing address) ❑Flood F7 Fire (- Liq [Landslide ❑N/A Floor Suite No
731 See�,,:Vj A��(�� C L
Description of Work
Use Ec; Const Type FtVTW
#Storiese #Units(ifRes)E_
New/AddSFF^; Remodel SF Garage/New/Add
Valuation $
Material/Labor) 1 1
OWNER'S NAME Last First bt"GHQ
Owner's Address Owner's E-mail Address
l(ooZ�S
City _ j State I Zip Telephoned.
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City State r — Zip Telephone .
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ARCHITECT/DESIGNER'S NAME Last First L Lic. No. L
Architect/Designer's Address Architect/Designer's E-mail Address
City _ _ _ _ State �; Zip F-1 Telephoned—'�
ENGINEER'S NAME Last First 7 Lic. No.
Engineer's Address Engineer's E-mail Address
City _ - - , State Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. g� 61 ClassF
Contractor's Address Contractor's E-mail Address
City State F— Zip Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. Vb i I _ !�(4I
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Zj � I- `Lt1
q �l
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $