HomeMy WebLinkAboutX2019-2818 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
I Comm'I F" Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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*uilding F` Grading F-Drainage ?-Elec 4Aech Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) F- Flood F" Fire F- Liq Landslide FN/A Floor Suite No
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Description of Work
Use 3'OW6nstType LiVjZjIVk
# Stories #Units (if Res) r—
valuation $
Material/Labor' S 1� 1' G Z1
New/Add SF�— Remodel SF % i'
Garage/New/Add
OWNER'S NAME Last First®
Owner's Address
Owner's E-mail Address
WWVA� it DTI
City '�(2��/ry6--.. State F7 \ _ Zip ,7 ?� Telephone '.. }.�'_ 2 ,),-
APPLICANTS NAME LastFIT11'
s First %_-<,
Applicant's Address
Applicant's E-mail Address
City �i�Z �- State F(A -�
Zip I C� (3 "� Telephone '?' - -';�'- Z j z,✓
ARCHITECT/DESIGNER'S NAME Last . t' �� P First F_F Lic. No. C
Architect/Designer's Address
Architect/Designers E-mail Address
City F h/,Vyrrj rz State
l" FC\
Zip �[ [ Telephone
ENGINEER'S NAMELast
First F Lic. No.FV
Engineer's Address
Engineer's E-mail Address
City State F—
Zip Telephoners
CONTRACTOR'S NAME/COMPANY J7 - Lic. No.
Contractors Address
Contractor's E-mail Address
`76 i�l2v itSG C
Cc tC1Y6,jC:,__W
City S,'2V , f�i'�®_. ...a� State �� Zip I C%(Z4, I p Telephone
SETBACKS REAR SETBACKS FRONT
SETBACKS
PERMIT NO. (j
PLAN NO.
LEFT SETBACKS RIGHT
CHECK
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $