HomeMy WebLinkAboutX2019-3667 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
rW Comm'I (" Residential City of Newport Beach - Building Division >
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL u
r Building F- Grading [-Drainage F_ Elec (-- Mech ru Plum CuYdCut l CuvdFill F
Project Address (Not mailing address) F Flood r Fire i_ Liq F Landslide I -N/A Floor Suite No
19 b j C07n '(�>A ivl L 0—) 6 I-t Cat 9-�—
Description of Work
Use ConstType�
New ` x S - +vib
# Stories #Units (if Res)
C' to ) -
Valuation $ f�
Material/Labor c
New/AddSFF— Remodel SF Garage/New/Add
OWNER'S NAME Last First J er-t_ 0� i,,,p,�
Owner's Address Owner's E-mail Address
-1, 6 5 1rC � i
City N 7> i7--.) State Tyr- Zip n Zz T TelephoneF_.
APPLICANT'S NAME Last First __,s c_
Applicant's Address Applicant's E-mail Address
2 Z oso ?(cx:U � TDZ
City � S A^ State CA- Zip FC�Z 6 Telephone C(� 1_6 l 7- "_0 G
ARCHITECT/DESIGNER'S NAME Last Q 0 (- i C, First . J C)5 L Lic. No. :'�cj �2
Architect/Designer's Address Architect/Designer's E-mail Address
_
2--I % j i, C2-.k S—f 1A
City State � Zip FcfZ�S Tel hone-9 Clio cl,-A --
ENGINEER'S NAME Last First Lic. No.F
Engineer's Address Engineer's E-mail dress
City State �— Zip Telephone
CONTRACTOR'S NAME/COMPANY �� -` P�Y��o56 �L Lic No. �Class
Contractor's Address Contractor's E-mail Address
city 2S-AA State ICA Zip �u�� Telephone C N�f
I
SETBACKS REAR ` 0 SETBACKS FRONT PERMIT NO. xZny'�
SETBACKS LEFT 5 SETBACKS RIGHT 5 PLAN CHECK N0.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $