HomeMy WebLinkAboutX2017-2006 - Permit ApplicationPrint Form Wo s eet for Combo Building & Solar Permit Application
r Comm'] Residential x City of Newport Beach - Building Division
k NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading Drainage );zElec XMech
Plum CuvdCut F_ CuVdFill F_
Project Address (Not mailing address) f Flood e r Liq r Landslide I -N/A Floor Suite No
2 ST. (LErtY CT,
Description of Work
Use Q-3 ConstType V-j3
# Stories # Uits (if R s)�
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Valuation$
Materal/Labor X'
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New/AddSF�� Remodel SF F11288 s.F- Garage/New/Addl/
OWNER'S NAME Last dAWr4Ar,-
Owner's Address
First CECIL
Owner's EI-mail Address
2 5T, Vgm,( C"(
C'♦rCILrIAw�M-1 -�' �1.CcM
City �g,,�Prz� "i'. '�t-I- State F
ZiP j12G5-7 Telephone �qc7 - Z73 -011 17
APPLICANT'S NAME Last I 5-rMD
First $T64E
Applicant's Address
Applicant's E-mail Address
2-
STF�EE'_ 57A.I)Atz-4rrbri5. corn
City I .Ante v1¢to State 1 M
Zip g2G$L Telephone -iq _ G-7-7-1)3o4
ARCHITECT/DESIGNER'S NAME Last $TAA0
5-TAAD tineti,frt-rs, tale.
First $TEE Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
2- AcwteA
STYE 5TA'+O fFfCCtIITECTS . �M
City so �telu State
Zip g2656 Telephone
Fin_
ENGIN�FER 5 NAME Last
First F Lic. No.�—
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No.FLK-74<Class
Contractors Address
Contractor's E-mail Address
City State F—
Zip F— Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ �W