HomeMy WebLinkAboutX2019-4175 - Permit ApplicationPrint_For n_' Worksheet for Combo Building & Solar Permit Application
❑ Comm'] ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building ❑Grading ❑Drainage ❑Elec ❑Meth ❑plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor
Suite No
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of Work
New/Add SFRemodel SFGarage/New/Add
Use E7ConstType I
# Stories❑ # Units (if Res)--I—JJJ
Valuation 1
Material/Lab
OWNER'S NAME Last I VA /Y / %� � /DEL 6,1 First To e /V 6 C �1
Owner's Address
Owner's E-mail Address
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City State Zip i"Z l/ Teleoh ne `7
APPLICANT'S NAME Last jh /✓ /'r C�� �/
Applicant's Address A
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City N _ _ State C/p Zip
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First) Ca/2it/�c f
E-mail Address
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Z66
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ARCHITECT/DESIGNER'S NAME
Last NJp /2 G // �/ First
JvH� Lic. No.
ArchitecUDesigner's Address ---Architect/Designer's E-mail Address - --
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ity Near _ /-t-/Zc
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i� /US ZrN State C Zip cf'Z7r,1 Telephone 7ir/ 2 6 (•
7
ENGINEER'S NAME Last
First Lic. No.�
Engineer's Address Engineer's E-mail Addressmai--I Addresr JJ
city
State Zip Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. I Class
Contractor's Address
I
City State F i
REAR SETBACKS FRONT
LEFT SETBACKS RIGHT
Contractor's E-mail Address
ZIP [ Telephone)
PERMIT NO.
PLAN CHECK NO.
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DEVELOPMENT NO %:�� (,—1 , C,;i ' -PLAN CHECK FEES $