HomeMy WebLinkAboutX2018-3251 - Permit Applicationx2 D I 32S 1
PrintCForm Worksheet for Combo Building & Solar Permit Application saw
r Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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rBuilding r Grading rbrainage rElec rMech r Plum Cu Yd cuc Cu Yd Fill
Project Address (Not mailing address) ri Flood r Fire r Liq Landslide r'N/A Floor Suite No
Description of Work TLMO tj6 Qx t / K ivi
UseF Const Type
#Stories; #Units (ifRes)F
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Valuation $ .i
Material/Labor
New/Add SF�— Remodel SF� Garage/New/Add
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OWNER'S NAME Last 1jZVfAjE (LO r First
Owner's Address Owner's E-mail Address
6-1-0 AIMVP6017 _CeelITSR�12tvg /5O
City N 55ti : {F l
State e /E I Zip 9zG�a Telephone
APPLICANT'S NAME LastTDkVE, First
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i! _ CA(. N
Applicant's Address Applicant's E-mail Address
73/_ �- ►ala i�v s7- ALO JVD
! Lr �- Zip Telephone
city Fa -ft e State sr
yzG B 7�y) z3/ - Sz43
ARCHITECT/DESIGNER'S NAME Last(vow/,/� First F Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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City !. State F Zip I Telephoned.
Last First Lic. No.
ENGINEER'S NAME 11A -
Engineer's Address Engineer's E-mail Address
City State ��; Zip Telephone
CONTRACTOR'S NAME/COMPANY / G JS 3D Lic. No. Z6(oS3 ;Class BBV 4r;
Contractor's Address Contractor's E-mail Address
73� /4r Fvin-rrl s7� __. cl��+w6@t)$3D•Cmw'
city .�gt; _...... State CA- Zip 7Z9G9Telephone 70)�,�`.- i�rZQ5
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2 C^W I X
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
0 �60�