HomeMy WebLinkAboutX2018-0885 - Permit ApplicationLL_PIrint FormWorksheet for Combo Building & Solar Permit Application
i7 Comm1 r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
nBuilding f -Grading FDrainage r-Elec rl,Mach r-PlumCuvdCut �', CuvdFui
- -
Project Address mailing address) ❑ Flood n FireF7Liq [] Landslide ❑N/A Floor Suite No
>(Not
Description of Work
Use F Const Type F
> d
wA- S� \
l \
# Stories # Units (if Res)n
2c,...Nb�
Valuation$ /J
Material/Labor , l jLJ
New/Add SF Remodel SF �,
Garage/New/Add
OWNER'S NAME�j��/�� r_� p�/�,
Last
First N
Owner's Address
Owner's E-mail Address
-
City 11 \/i �C% _ - State Zip Telephoned—
(NAME
APPLICANT'S Last ��l ���
_ II First
Applicant's Address
Applicant's E-mail Address
City !� ( -. State I �\
Zip _,.I^L1�„ Telephone\�\S�cs`-ice{
ARCHITECT/DESIGNER'S NAME Last First �� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City � ra State ��
S.o1"-�ba Yom. _ .. �''A
Zip -� "Llo�` li Telephone
----=
ENGINEER'S NAME LaK - -
- - - First Lic. No
Engineer's Address
Engineer's E-mail Address
City StateF
Zip I Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. 165\_L; Class �(
Contractor's Address
Contractor's E-mail Address
City -- -. _-_ _--------_--_ State
Telephone 3l -1 S
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. TTZ yoC.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ �7Z