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HomeMy WebLinkAboutX2016-1078 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application r'; Comm'I r Residential City of Newport Beach - Building Division X to l la -1075 75 NOTE: PLAN CHECK FEES DUE AT TIMF OF SI IRMITTAI v rBuilding r— Grading rDrainage r';Elec r, Mech F— Plum cu yd cut Cu yd Fill °j Project (Not mailing address) r_1 Flood Fire r Liq r; Landslide rN/A F� Suite No pAddress nr So✓ ��gU �l1 *ve- uJ cin CA Description of Work User Const Type I G e ii # Storiesf—il # Units (if Res)F— Valuation $ e Material/Labor New/Add SF�— Remodel SF�— Garage/New/Add �—'; OWNER'S NAME Last IG.VSc Q�- �y1UG'S}"M ' First ��� �e �� Owner's Address Owner's E-mail Address City ILS ty�tl.✓�,.J.._.� State l �� rc;r Zip I Telephone��D. ! APPLICANT'S NAME Last ..... ___ First Applicant's Address Applicant's E-mail Address CL e- City W,,4-m',0-� ,. State Zip Telephone�� �Z�3 (�{—�72a ARCHITECT/DESIGNER'S NAME Last First F Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip Telephone ENGINEER'S NAME Lash First Lic. No. Engineer's Address Engineer's E-mail Address city State' Zip Telephone __. _.. CONTRACTOR'S NAME/COMPANYLic. No. Class Ds �� Sfc oa �5 Lltc, 852 5 Contractor's Address Contractor's E-mail Address 0 vi S-11 Ta - City wC� YYI ri5 State F Zip - 1�� /% Telephone 7f,(47—o jo SETBACKS REAR SETBACKS FRONT PERMIT NO. , V • SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. t USE ZONE DEVELOPMENT NO PLAN CHECK FEES $