HomeMy WebLinkAboutX2019-3440 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �RAr
�mm'I esidential City of Newport Beach - Building Division L ie
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
R*ilding F_ Grading F Drainage F-Elec rMech F_ Plum Cu vd Cut F_Cu Yd Fill
Project Address (Not mailing address) f Flood F_ Fire r Liq r Landslide F_N/A Floor Suite No
G/4C- 1JAyW00D A10Al2_7,-225—
Description of Work
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# Stories # Units (if Res)
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New/AddSFF_ Remodel SF�— Garage/New/Add
Valuation S 14Fb00
Material/Labor
OWNER'S NAME Last 771 /,,P—(//tie_ (!�20 First
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Owner's Address Owner�E-mail Address
City State Zip TelephoneF!
APPLICANT'S NAME Last / �(/A x First ,ay
Applicant's Address Applicant's E-mail Address
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City bA160A blAiVC> State Zip / �� Telephone - f
ARCHITECT/DESIGNER'S NAME Last �L�4N/�j/t—� First ;�4AA_).Dt/ Lic.N
Architect/Designees Address Architect/Designer's E-mail/Address /
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City _ State Zip F Telephoned
ENGINEER'S NAME Last First F_ Lic. No.F—
Engineer's Address Engineer's E-mail Address
City - State F Zip F Telephoned
CONTRACTOR'S NAME/COMPANY 1 ,� n� VC4)1,0 � Lic No. 5 E 7q? Class F
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Contractor's Address Contractor's E-mail Address
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City �1,� f) O State I " Zip N'` 10 Telephone 71 N . LlG 60 ZS
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SETBACKS REAR SETBACKS FRONT PERMIT NO. _3tyy
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 'j`�.�- Zr)
USE ZONE DEVELOPMENT NO PLAN CHECK FEES S