HomeMy WebLinkAboutX2018-1718 - Permit Application/Worksheet for Combo Building & Solar Permit Application
F Comm'I h Residential City of Newport Beach - Building Division �-71� o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F-GradingF-Drainage
F-EIec Mech Plum Cuvdcut[- cu Yd FillF
Project Address (Not mailing address) C Flood i Fire r- Liq F- Landslide [N/A Floor Suite No
Description of Work
Use F_ Const Type
# Stories n' s i Res)
aluation
Material/L 'I ,
Waw
'., r �p ;Loo t< t �; e r( ��6Kt'_
J '114
New/Add SFI
Remodels j n rage/New/Add F
OWNER'S NAME
Last A-G.4711� First TG c�/1Ii,L.- _
Owner's Address
Owner's E-mail Address
',r�i�/�
City I_ �7v V'9 �"�-
/ q G /l�7G 0�.
� U�� _ State I c--' \ r Zip ��` b 0 Telephonel 1. I '6 ! 1 ! l
APPLICANT'S NAME
Last ; First
i
Applicants Address
Applicant's E-mail Address
City
State F_ Zip �—' Telephone
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No.
Architect/Designers Address Architect/Designers E-mail Address
City
—
State �- Zip F TelephoneF
ENGINEER'S NAME
Last l First Lic No. n
Engineers Address
Engineers E-mail Address
City 1
State i Zip IF Telephoner
CONTRACTOR'S NAME/COMPANY I/��(/(�/ Lic.No. 9}72f Classi�—
Contractor's Address
Contractor's E-mail Address
y
City VL1
State �ii Zip 1 f �"" �' i Telephone � 41_ �-t
NO.
SETBACKS REAR
SETBACKS FRONT PERMIT
SETBACKS LEFT
SETBACKS RIGHT D PLAN CHECK NO.
USE ZONE.
nmim nomrNT NO PLAN CHECK FEES ...... - _. ....