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HomeMy WebLinkAboutX2018-3335 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ,<Comm'I r Residential City of Newport Beach - Building Division �` 546'-20!8 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X9018-33359 Building r Grading r Drainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing r Flood j- Fire r Liq F e rNIA Floor Suite No G 1��� D_ _ �aQdd�ress) U I/��X/V Description of Work FTQ— Use 1 to Const Type 20 I #Stories #Units (if Res) Valuation $ Material/Laborr New/AddSF1 Remodel F Garage/New/Addy _ OWNER'S NAME /�� Last ifJ V VLU Q ��C First CI � SW' Lucaly ' ` v Owner's Address Owner's E-mail Address 2301D "VW 6W. ( b City F YgT* State0/1— Zip I `�2 TelephoneF_ APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City � State F_ Zip F— Telephone ARCHITECT/DESIGNER'S NAME Last 'First r- Lic. No. F_ Architect/DesigneesAddress Architect/Designees E-mail Address City I _ State F Zip F Telephone ENGINEER'S NAME Last �-� First F_ Lic, No. F_ Engineer's Address Engineer's E-mail Address City � State F_ Zip F— Telephoner--_- CONTRACTOR'S NAME/COMPANY I D t NC Lic No. q $'� SS Class Contractor's Address Contractor's E-mail Address i0 to 5. l -f" fl,, r,✓Uy 5t. f c N4o City I sc,„v -fc A ` State FC4 Zip Ra 7o ,F Telephone 7/6f-�C-0 0177 SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $