HomeMy WebLinkAboutX2019-4038 - Permit ApplicationPrint Form Worksheet for Combo Building,
f Comm'I F Residential City of Newport Beach
NOTE' PLAN r.HFr.K FFFc nl I
& Solar Permit Application
Building Division
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F-Building F_ Grading (-Drainage � Elec f' Mech . Plum j F_ Cu
Cu Yd Cutl Yd Fill
Project Address (Not mailing address) F_ Flood r Fire F- Liq Landslide F_N/A Floor Suite No
/7 J 27 e�V,6o
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Description of Work
Use F— ConstType
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# Stories #Units (if Res)
Valuation $
Material/Labo A-Sa) Oo 0
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Nt�w aor ►U�1 M1.
New/Add SF —5'3 Remodel SF
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Garage/New/Add
OWNER'S NAME Last �-
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First S7ry
Owner's Address
Owner's E-mail Address
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city State C �-^ Zip cs.�.GL a Telephone Qy.E 111 1 --O5"T%
APPLICANT'S NAME Last1
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First �F}J
Applicant's Address
Applicant's E-mail Address
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City G } (n� o ` State
Zip qt Zo } Telephone
ARCHITECT/DESIGNER'S NAME Last 3 J(2i
� First Lic. No. F�
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Architect/Designer's Address
ArchitectlDesigner's E-mail Address
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J-� C\2
City �(�\ P State —
Zip Tele hone[c
ENGINEER'S NAME Last S j2G2
First
rst C13 Lic. No. 3SSS
Engineer's Address
Engineer's E-mail Address
8 c�RN� ALL\ S
city State Cat-
Zip Telephone
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CONTRACTOR'S NAMEKOMPANY Lic No. Class r
Contractor's Address
Contractor's E-mail Address 3Slo 1b,.
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City �� State ��
Zip �` Telephoned`
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X�I 1LT
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO. 2� 2.2nt
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $