HomeMy WebLinkAboutX2019-2229 - Permit Application, nnt'Form : Worksheet for Combo Building & Solar Permit Application �
F
Comm'I Residential City of Newport Beach -Building Division d;
NOTE: PLAN CHFCK FEFC nl IC AT TiRAM nc ON IoRA �-.
1
Building j-. Grading ec F-Draina e ech
9 � 'IUm Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F Flood ire r; Liq F-' Landslide I -N/A Floor suite No
Description of Work
Use �, Const Type
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_ —_i
# Stories', # Units (if Res)
New/Add SF�— Remodel 5F — �
-- - - - _ -_-, �� .
Gar
Garage/New/Add � �
Valuation $
' � C.i
Matenal/La - r - /
OWNER'S NAME 1
Last �t _I G
First
Owners Address
1A15city,
Owners E-mail Address � '( _ �Z'7 _ '
---- — State Zip—j Telephone—
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City _ _ State
Zip
ARCHITECT/DESIGNER'S NAME Last 1
�: First r ��Lic.No. �-
Architect/Designers Address
Architect/Designers E-mail Address
city JI State
- - - ---
Zip �- Telephone��
L
ENGINEER'S NAME Last } _ - _
First F Lic. No.
Engineers Address
Engineer's E-mail Address
- _- — �'
City I State
ZI p TelephoneF7-7
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractors Address
Contractors E-mail Address
-- ---
City I State �
Zi Telephone I
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE �-ry\ DEVELOPMENT NO
PERMIT NO. Z- G(
PLAN CHECK NO. `L Z-6)
PLAN CHECK FEES $