HomeMy WebLinkAboutX2019-2122 - Permit Application (3)Print Form Worksheet for Go
mbo Building & Solar Permit Application A_541A
F Comm'I %Residential City of Newport Beach - Building Division
NOTE' PI AN r.WFr l< PPPC ni IM A� T1.11111 �.,..��.
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f 7 uilding r Grading j—Drainage [_ Elec r Mech Plum Cu Yd Cut — Cu vd Fill \J
Project Address (Not mailing address) F Flood/ F_. Fire F_ Liq F Landslide 1-N/A Floor Suite No
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Description of Work
Use Const Type '\%6
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# Stories
[ #Units (if Res)
�Rem.�IeISF
dl:, ,.t� /4,1oll �J -A- fi Valuation$
New/Add SF z l Garage/New/Add Material/Labor
OWNER'S NAME Last CfJ'CJp {./f First C�
Owner's Address
Owner's E-mail Address
City - - -
/Lt.W'-_.>� Ja�C State �� ZiP �>>(`� Tele honed t' - �, APPLICANT'S NAME Last /
�1�1 S First
Applicant's Address
Applicant's E-mail Address
City ki. State ZipG Telephone
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ARCHITECT/ IGNER'$-NAME
- Last CC r� p---"l�l\ First - / :, Lic. No. —'
Architect/Designer's Address Architect/Designees E-mail Address
/ Lot-
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City (yi L�l r ' '1 L-� - State E^ ZiP PU _C Telephone -ce- s' 7 a - "75
ENGINEER'S NAME t ' f —=
Last XC � I .�// First ie q k7de Lic. No. L 7 �c
Engineer's Address Engineer's E-mail Address
City LC[lC :.� e;\C ) State GR Zip ek;<,— O, Tele honek�,-z V4
CONTRACTOR'S NAME/COMPANY ire Cotes; Inc Lic. No. .� Class FJi
Contractors Address C V! v� Contractor's E-mail Address
1 � 13 L i wt�e� � t c. I� �A2oruC Z 9 1� ` . C-0 V�.
City �! 6 5r F*—vu�c5 p State F—C ZiP Telephone —TI sY
SETBACKS REAR _ SETBACKS FRONT PERMIT NO. n ^ — ZA L'L_
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ,SZ7
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $