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
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Project Address (Not mailing address) F Flood r Fire r Liq r - Landslide r -N/A Floor Suite No
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Description of Work .• . °
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#Stories # Units (if Res)
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New/Add SF Remodel SF
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Garag a/New/AddF
Valuation
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Material/Labor
OWNER'S NAME Last 01 B ®
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Owner's Address
Owner's E-mail Address
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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
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City toh� Aeby—�— State CA
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Zip F_ Telephone ] 6 �e 2tij _ /� O�'>
CONTRACTOR'S NAME/COMPANY
Lic. No. r7I 3_a j Class
Contractors Address
Contractors E-mail Address
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City State
Zip ��C3 Telephon /j�) 'YqS-_ ' l
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SETBACKS REAR SETBACKS FRONT
PERMIT NO_
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES