HomeMy WebLinkAboutX2018-2687 - Permit Application (2)9020W Z(B1-
Print Form, Worksheet for Combo Building & Solar Permit Application
Residential
City of Newport Beach - Building Division
NOTE. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building Grading
Project Address (b
❑Drainage ❑ Elec ❑ Mech ❑ Plum cu Yd cut
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address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide C
N
Description of Work
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7VU10r^ D,ij Q L c� c.A-m n+S
New/Add SFF----7 Remodel SFF77I Garage/New/Add �I
OWNER'S NAME Last
Owner's Address
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City �1/LtwNoR.T_A%AG(f State
APPLICANT'S NAME Last
First
Owner's E-mail Address
Zip
First 1
151
Floor Suite No
F77 F_7
Use F7 Const Type n
# Stories17 # Units (if Res)❑
Valuation $
Material/Labor b U1oo�
Applicant's Address Applicant's E-mail Address
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City L __ State C/4- _ Zip F" `Ct; o Telephone � (y, y o 2 y t t
ARCHITECT/DESIGNER'S NAME Last �— ' First F Lic. No.
ArchitecttDesigner's Address Architect/Designer's E-mail Address
City—� State Zip C Telephone��
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
Wd1r&LL,c{ oe-4C6, /!2 Lrl62tSati/ �'' 662 w65T. caNt
CityN, a State C,Q Zip o/ 2GC a Telephone[5Y5
`(S
LA �,S-
CONTRACTOR'S NAME/COMPANY Lic. No. Class 1
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Contractor's Address Contractor's E-mail Address
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City ��fYi R{. State Gk} zip 1 Z% Telephone6164
SETBACKS REAR
LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $