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HomeMy WebLinkAboutX2017-2492 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application«°°^a City of Newport Beach - Building Division f- Comm'I j Residential NnTF- Pl AN CHFCK FEES DUE AT TIME OF SUBMITTAL [-Building j Grading F -Drainage Vl-Elec I-Mech F- Plum Cu rd Cut Cu Yd Fill Project Address (Not mailing address) Flood F_ Fire Fi Liq (- Landslide F-N/A� Suite No ,Floor � Description of Work Use i Const Type F_ ri " 1 (� ^� �t # Stories # Units (if Res)F— Valuation, New/ dd Fj ^ Remodel SF�— Garage/New/Addy Material/Laboi OWNER'S NAM11--"' Last I _ First Owner's Address Owner's E-mail Address City _ _ State I I -, Zip { Telephonei LICANT'S NAM Last i ( First ( "J( e ter. A ressj]1 Applicant's E-mail Address } �s ' ��CiJ7` C C•'''°`�/9 r l__5'l�� 6 i f�Ia`'"ddg'�.Aw,�f>�,} d� 6C.�`�Q. � Ci jN,� ^(��`.(/1J /O) ✓ r; -' ,State ( j.--- Zip Cu ''/q [{� Telephone Abp r `" , ` J� �.� ARCHITECT/DESIGNER'S NAME L st� q��`�/ First 1_ Lic. No. J ArchitectlDesigner's Address Architect/DesigneCCCrJJJs„ Cit}, 11 State Zip, Telephone) ENGINEER'S NAME Last L1 1 First��- Lic. No. Engineers Addres Engineers E-mail Address c City WL State A Zip%AYI Telephone(�/I— , CONTRA OR'S NAME/COMPANY 5 Lic. No. { d Z C Class .J Contractor's Address Contractor's E-mail Address �PIC,T °/ZAT,� '5T ;�m��icc City I State 1- Zip, C/ %/ (� Telephon F SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N 6. USE ZONE DEVELOPMENT NO - ..... .. PLAN "CHECK FEES $"...