HomeMy WebLinkAboutX2017-1822 - Permit Application (2)X?O17�1&2�
Print Form W eefq Combo Buil
din comm I j�,✓ din g Solar inion Application
[- €SEW
Residential �� City of Newport Beach - Building Division
(—Building
:N E: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r Grading p
e 17Elec. �I,Mech ❑Plum cuvdtut
Project Address (Not mailing address) [ Flood [ ` Fi a, Yd Flu
i
1 q ❑ Landslide []N/A Floor Suite No
Description of Work —
y I� —
Use Const Type
-
y,� # Stories #Units (if Res) I
New/Add SF�-' I Remodel SF ��- Valuation S J C
Garage/New/Add
R'S NAME Last I Material/Labor
OWNE�-----.__
i �- -
_ First
Owner's Address - - -- _
Owner's E. res ..
- -- --
City-
-- - -- state �- --- - -- --
_ '
APPLICANT'S NAME -_.. Zip `I Telephoned ---
Last
__ _ I First
i
AppllcanfSAddress
Applicant's E-mail Address
City �-
State ! Zip Telephoned
- -
ARCHITECT/DESIGNER'S NAME - -
Last {
-J
Architect/Designer's Address First Lic. No:
_ Architect/Designer's E-mail Address -8-
City
State Zip F_____ 7 Telephoned
ENGINEER'S NAME
Last-
-:.IFirs-�-En
Engineer's -
Lic. No.j''�' !I
Engineer's E-mail Address
City -
State - - - - - - --�
Zip Telephoned
E
CONTRACTOR'S NAME/COMPANY
/�_�iL�4 �GsLLA 'r7Ed,-� Lic. No. 807�f(7S Class
Contractor's Address -- -- -- I
2 3 F�j 2 Contractor's E-mail Address
City
�f1SSM� V'/ -G State
G'iJ— i Zip 9Z'2J Telephone
SETBACKS REAR !
SETBACKS FRONT
SETBACKS LEFT .SETBACKS RIGHT - PERMIT NO.
USEZONEs- A —_• PLAN CHECK N.
DEVELQPMFNT Nr) T— -
M1 nni rucru rare a ..«=_.:ii^'Y