HomeMy WebLinkAboutX2018-0378 - Permit ApplicationAZO V; b 7
Worksheet for Combo Building & Solar Permit Application
r Comm'I KResidential
City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEESDUE AT TIME OF SUBMITTAL
rBuilding F_ Grading rDrainage Elec, j-Mech Plum cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) Flood (-• Fire r Liq r-, Landslide FWA Floor Suite No
Fie
Description of Work 1f& 1_111!_
` / _ Use Const Type
f!/!/
# Stories # Units (if Res)
ZA6e, &471L
Valuation S y
New/Add SFRemodel SF y� Garage/New/Add Material/Labor ( /
OWNER'SNAME Last /tj First
I
Ownees.Address Owner's E-mail Address
a3o 114��
City / state L/G..Zip Telephone,IL
�O •�O��o
APPLICANPS'NAME Last ✓,tires✓ First
Applicant'sAddress Applicant's E-mail Address
0?3 04%C
City �( State�Zip�� Tel
ARCHITECT/DESIGNER'S NAME Last Q/Yj �py� First D rc. No. C-Zy ZZ
Architect/DesignersRddress Architect/Designer's E-mai ddtess
City g/-v A&W StateE /F' Zip 4/'Z-6-Z�/% Telephone �/�,G67- 5 ✓✓tvz�-
ENGINEER'S NAME Last First F Lic: No.1—
Engineer's Address Engineer's E-mail Address
City State Zip Telephoner ,
CONTRACTOR'S NAME/COMPANY 7"dyAIRAI No. /�f Class
Contractor's Address Contractor's E-mail Address
, .
City Sfa a -% Zi I / " r( �elephoneC-
SETBACKS REAR SETBACKS FRONT PERMIT NO. Vtlo
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. O Q s
�17E. (�E` /ELO7�lYEFIfN25.,`®.`•.. __ _ F Y CnEGK