HomeMy WebLinkAboutM2018-0079 - Permit ApplicationM201&6 -00-7cj R -CP ri t� #- 2 q-- q -2 01 �?'
. > Worksheet for Combo Building & Solar Permit Application
'�<Comm'I r; Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) ❑ Flood ❑ Fire X Liq [ Landslide [N/A Floor Suite No
Description of Work
Use � ConstType
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# Stories # Units (if Res)
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New/Add SF Remodel SF I,GI S 1 _i Garage/New/Add
Valuation 5 /✓ O
Material/Labor 97
OWNER'S NAME Last IRVINC CpMPI�(V I First
Owner's Address Owner's E-mail Address
City Ljjr v_State �� Zip Telephone --2'66
APPLICANT'S NAME Last ell;First C(7Srvl i %'zL Pak kr.E I
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Applicant's Address Applicant's E-mail Address
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O(1__ State ' Zip 9 __ (� - Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No. 1
Architect/Designees Address Architect/Designer's E-mail Address
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City �— _ State �i Zip F-77-7 Telephoned
ENGINEER'S NAME Last First
_- j First LIC.No. 59gT8
Engineer's Address Engineer's E-mail Address
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City Jell r.a kq„q State w %} Zip 9 $ Z ILC j Telephone 3 c. oT, (0 f _F --t
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-QNAMEXOMPANY
CONTRACTOR'S
L—Ti Lic No.
Contractor's Address Contractor's E-mail Address
City �— ( State Zip L — TelephoneF—
SETBACKS REAR SETBACKS FRONT PERMIT NO. V)241? 00%
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ICY
USE ZONE DEVELOPMENT NO I / W� '-'�Ca' s-OPLAN CHECK FEES $
37