HomeMy WebLinkAboutS2018-0118 - Permit ApplicationStg , 011b
Print Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK. FEES DUE AT TIME OF SUBMITTAL
Building j– Grading aina a Elec Mech .- fum CuvdcutF 1
g � Cu Yd Fill
Project Address (Not mailing address) Flood F_' Fire F–j Liq [7 Landslide [iN/A Floor Suite No
71
140
Description of Work UseConstT e
4q(05 yp
#Stones' # Units (if Res)C
Valuation $ -.[c ,Gd/96
New/Add SF � Remodel SF�� Garage/New/Add Material/Labor'-.l
OWNER'S NAME Last
Owner's Address
City A L%� I State
APPLICANT'S NAME Last
First
Owner's E-mail Address
ME
Applicant's Address
l Quo -- -- -!
City State t 'LL._ ---j Zi
p
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City ----_ -_– State
First 1_ _1-1241
int's E-mail Address
IF
First Lic. No. L –1
Architect/Designer's E-mail Address
Zip l i Telephone'
ENGINEER'S NAMEi
Last _L�- ---� First – Lic. No. % k,,(�
Engineer's Address
City gk4Ae-1 ff/,— --- ---- .State _
CONTRACTOR'S NAME/COMPANY
Engineer's E-mail Address
Zip �]i ` ° r� Telephone _& 36 - 4j1,0C)
--R� s Lic. No. ClassG
– -- — --
Contractor's E-mail Address –111 i.Q ua
Contractor's Address
T4-,ZVrSW Pd
City Zj g_ e 1-,�,.{� ''( -.. State.
Zip 11 2,Cv3a Telephonel 4707- &2y
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
j'), 2— �
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $