HomeMy WebLinkAboutX2018-1336 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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F Comm'I j` Residential City of Newport Beach - Building Division /0 5i4 -,Z01$
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X.2019
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Project Address (Not mailing address) I— Flood f- Fire r Llq r Landslide rN/A Floor Suite o �Yy� LaA(, C ----W- F No
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Description of Work I n r
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New/Add SF� Remodel SF 22 Garage/New/Add Valuation $ 3
Material/Labor &o
OWNER'S NAME Last�I First �('-'1�101-
Owner's Address
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Owner's E-mail Address
Qer�L �h�
city IV QA7F_) State CA
Zip f�, Telephone�
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PPLICANT'S NAME Last Richart
First Jason
s
Applicant's E-mail Address
(A106) Jason@richartdesign.net
State CA Zip 92627 Telephone 949-422-9191
ARCHITECT/DESIGNER'S NAME - - —
Last Richert First Jason
Lic. No.
ArchitecttDesigners Address
ArchitecUDesigners E-mail Address
1041 W. 18th St, (A106) Jason@richartdesign.net
City Costa Mesa State CA Zip 92627 Telephone 949-422-9191
ENGINEER'S NAME Last GHAZLANI
First ANDY Lic. No.�,
Engineer's Address
ZEngineer's E-mail Address
City iS�h� tom_ State �_ p /
A Zip q®8®7, Telephone 662-`-53--2395
CONTRACTOR'S NAME/COMPANY O
Lic. No. �� Class
Contractors Address
Contractors E-mail Address
City y State F Contractor's
FTelephoneF �
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �� I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1 o �'�-t1�r,
�. 1 a
USE ZONE DEVELOPMENT NO
PIAN CHECK FEES�$
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