HomeMy WebLinkAboutX2017-2334 - Permit Applicationa4�EWF0 �
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division °Gaup
Comm'[ esidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building 7 Grading (—Drainage Elec ��,
Mech llDplum CuvdCut- CuVdFill F
Project Address (Not mailing address) C Flood i Fire r Liq r Landslide F—N/A Floor Suite No
Description of Work
I cs,o v" �ll�iLUl't It
New/Add SF; Remodel SF
OWNER'S NAME Last
Owners Address
Use � �,Co�nstType F_
# Storiesi �i��# Units (if Res)F
—
Valuati n $
Garage/New/Add FMaterial
First
Owners E-mail Address
City, State M�� Zip Telephonel
APPLICANT'S NAME Last First
Ap licant's Address Applicant's E-mail Address
City NN State .I �-[�. Zip �� TelephonelL`�
ARiHITECT/DESIG ER'S NAME Last I —V , First 1i Lic No.
Architect/Designers Address Architect/Designers E-mail Address
city ity e i Zip Telephones
ENGINEER'S NAME Last First
Lic. NoT�
Engineers Address Engineers E-mail Address
j State Zip Telephoned
City ,
Lic. No. F-Fff2�0 Class
CONTRACTOR'S NAME/COMPANY Z 1
Contractors Address Contractors E-mail Address
City ./V V�tA OLD State zip
Telephone, I S Z
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. IlOS�2 ' L�I'I
11 -- NE DEVELOPMENT NO PLAN CHECK FEES$