HomeMy WebLinkAboutX2018-0405 - Permit Application033`1.9015
X20691-0405
Worksheet for Combo Building & Solar Permit Applica ion
F- Comm'[ r Residential City of Newport Beach - Building Division l/L
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 4w.
Fbuilding (-Grading F -Drainage FElec )rMech F-_Plumcu Yd cutF TO
Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire F- Liq; F- Landslide +I:" A Floor Suite No
Description of Work UseConstType
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N�%inZ(�CJ �lZl-0 ) PA 2UU E M t r '-k" _ ° g Storiesf2', ' # Units (if Res)
9Ct Valuation $
New/Add SF Re odeI SF 3000 Garage/New Add q� Mzferial/Labor
OWNER'S NAME Last J= 9 w Ne -y- First J
Owner's Address Owner's E-mail Address
r'v90 ICIN GS,,... ` 'I iZD �pStgi3 #'1 N N�`C�` �LaHCSQ . OQ M
City � State G,L: ZiP 1 3 Telephone � �n
APPLICANT'S NAME Last, First
Applicant's Address Applicant's E-mail Address
City M A State �� Zip Il T Telephone�00 � 6
ARCHITECT/DESIGNER'S NAME Last Q First 16 Lic.No.r
Architect/Designers Address Architect/Designer's E-mail Address
Ci State G/J Zip 9, .` Telephone
" C��A M'�S 11 � �Z'7
ENGINEER'S NAME Last Fast jf Lic. No. 6,53
-:Engineer's Address Engineer's E-mail Address
tt zit GtAra(Xr4 ►126 L.Mlr�3b10f-407 c ciMAIL
, 'N t State ImoZip"City Z8;k� Telephone 7K 0Is,z,-35-6
CONTRACTOR'S NAMEXCIMPANY o�hN Co N sTa(x 10$4 Lic. No. `103655 Class
Contractor's Address Contractor's E-mail Address
Z�SZZ V�aL :.G/htt� OR-lb.�f.OP4 i co N 4.
City State I r" Zip Telephone I -jI qs}6 3
' SETBACKS REAR tooSETBACKS FRONT -2D, PERMIT NO. X Zn t 7 -- o `!o-5
`i�
SETBACKS LEFT ' SETBACKS RIGHT 4' PLAN CHECK NO. ()31,? 7 2
USE ZONE Q b DEVELOPMENT NO PLA HECK FEES$