HomeMy WebLinkAboutM2019-0028 - Permit ApplicationPrint For Worksheet for Combo Building & Solar Permit ��/,V' J
Comm'I City of Newport Beach - Building Division " ' O
(- F_ Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT
wilding F_ Grading F-Drainage F_ Elec F_ Mech F-. Plum Cu Yd Cutcu Yd FIII
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Project Address (Not mailing address) [_ Flood F Fire F_ Liq F-C dslitJ� ?it-Tvo
Description of Work
Use ConstType
To GaN X N
S
# Stories[— # Units (if Res)'
Valuation $
Material/Labor
New/Add SFI Remodel SFF-77--, Garage/New/Add F
OWNER'S NAME Last f?,y? - First
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Owner's Address Owner's E-mail Address
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City 1 State F6+ V&T V9 Q "f (�rC
Zip Telephone / ePYbs
APPLICANT'S NAME Last _ First D�
Applicant's Address Applicant's E-mail Address
6 �dN7" �l'UF
City State ' ` i ^`-"`��T 5 Zip D Telephone ; Zy� /4, -
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LLiic`.'No. �—
ARCHITECT/DESIGNER'S NAME Last �First -.
Architect/Designer's Address Architect/Designer's E-mail Address
City �— State F ZipTelephone
ENGINEER'S NAME Last �J V� First ugze_ Lic. No. C
Engineer's Address Engineer's E-mail Address
IGov E. /&111, s7jr-Er, u,vir 'p c a leCa eSc phe
City I �� t' "r r�' ,Wlf State I C�;r Zip l Telephone 7j��— zo/
CONTRACTOR'S NAME/COMPANY rU C l A l ! I Ft( P STp JC j otjsLic. No. S T) j ,� Class
Contractor's Address Contractor's E-mail Address
2701 tkl- CCAST HWy, J �k`I C- J4 I -T oichqSLA95(_ RFcDP6CiFl,c.cc,0-1
City I IJC �,'[MT BLOC/-% State CR Zip l2,663 Telephone C{�{ -ZC. M-t{C(I0
SETBACKS REAR SETBACKS FIR RMIT NO. P1 /tfll . ([)UZ,D
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No. ' -2-0 L
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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