Loading...
HomeMy WebLinkAboutX2018-2399 - Permit Application_PrmtForm Worksheet for Combo Building & Solar Permit Application r- Comm'I r Residential p City of Newport Beach - Building Division {qQq -X18 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 20/g.,23gq rBuilding F_Gradingr-;Drainage jElec I- ech Plum CuvdCut Cu Yd Fill Project Address (Not mailing address) F Flood r Fire r Liq r - Landslide r -N/A Floor Suite No Iq10 WarcutcK-lana- F_ �- Description of Work .• . ° Use S � CvnstType V/ S _j ,c4n #Stories # Units (if Res) - , New/Add SF Remodel SF iy Garag a/New/AddF Valuation abor c� � Material/Labor OWNER'S NAME Last 01 B ® -h First ora 0. A I e Owner's Address Owner's E-mail Address O AZknMc_ y,,e City I Ngo ,,j Poirt INW State CA Zip F� Telephoned APPLICANT'S NAME Last Richart First Jason Applicant's Address Applicant's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.not City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. ArchilectlDesigners Address Architect/Designees 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. 6 g l Engineer's Address Engineer's E-mail Address X1262 A iani_ CAVE' ZOt 5a I City toh� Aeby—�— State CA j Q Zip F_ Telephone ] 6 �e 2tij _ /� O�'> CONTRACTOR'S NAME/COMPANY Lic. No. r7I 3_a j Class Contractors Address Contractors E-mail Address �VF ✓J6 S l iC- �IG�wS(laUSi�u¢ i vJr,l Lh�2a L.Co City State Zip ��C3 Telephon /j�) 'YqS-_ ' l n m SETBACKS REAR SETBACKS FRONT PERMIT NO_ SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES