HomeMy WebLinkAboutX2019-1668 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F` Comm'I r✓ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F- Grading Drainage F_ Elec F_ Mech F Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) F- Flood F_ Fire F` Liq j- Landslide F_N/A Floor Suite No
Mot I;ALAx EW Pop.T tpc.fk (::�_A F_ F—
Description of Work
Use ConstType
D�Iv�WA
'F
ca �n�
# Stories #Units (if Res)
Valuation $
Material/Labor
New/Add SFF— Remodel SF
Garage/New/Add F-
OWNER'S NAME Last W49-
First qNE---
Owner's Address
Owner's E-mail Address
1401 LAx
City NI�fww-r State �- Zip Telleephone 944) q33 3W
APPLICANT'S NAME Last $�
First DAVF�
Applicant's Address
17-0 N yT M
Applicant's E-mail Address
av c fv o A . In d1P9 eo . cc M
City u OND State CA
Zip 9n8 Telephone1t?b1 2*6S46 7fl
ARCHITECT/DESIGNER'S NAME Last F
First [_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City F — State F_
Zip F_ Telephone��
ENGINEER'S NAME Last F
First F_ Lic. No.F
Engineer's Address
Engineer's E-mail Address
City [_ State F_
Zip [_ Telephonel�
CONTRACTOR'S NAME/COMPANY ry,,,c -/
�(1.,, j Lic No. 70 Class _1
N�Coonnttraactor's
Contractor's Address
E-mail Address
72o N 5-r A-E
al:km brewn,w,aSonr Colo oo,RA
City � LAN � State CA
Zip F9 1 7 gG Telephone q 09 Z4!' 6 6"r�
1 p 00 67
SETBACKS REAR SETBACKS FRONT
PERMIT NO. X � q -16617
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $