HomeMy WebLinkAboutX2019-0049 - Permit ApplicationWor sh et for Combo Building & Solar Permit Application oF9 ° e
j Comm'I I VResidential City of Newport Beach - Building Division g'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building 1 Grading rainage F_Elec ( Mech
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Project Address (Not mailing address) F_ Flood j— Fire F_ Liq F_ Landslide F_N/A Floor Suite No
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Description of Work 01-0 y/
Use d ConstType )/-Q
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Valuation $ ,0,,'y��y
Material/Labor (, 0
New/Add SF F_Remodel SF F— Garage/New/Add
OWNER'S NAME Last V/'G
First
Owners Address
Owner's E-mail Address
City State I
Zip F_ Telephoned®
APPLICANT'S NAME Last 'T17-vA)4
First I J'A
Applicant's Address
Applicant's E-mail A,tddress
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Zip g� Telephone *q- 4;;5J
ARCHITECT/DESIGNER'S NAME Last 71/(f/ �� First IZAIUD) Lic. �.L���[sJ�
Architect/Designers Address
Architect/Designer's E-mail dress /
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City State �—
Zip F— TelephoneF
ENGINEER'S NAME Last
First Lic. No.F®
Engineer's Address
Engineers E-mail Address
City State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. Class,
Contractor's Address
Contractors E-mail Address
Ci �� State �—
Zip i Telephone)
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK N r
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $