HomeMy WebLinkAboutX2013-1630 - Permit Applicationi
;- Comm']
ing Division
,�+ Worksheet for Combo Building & Solar Permit plication
�( Residential NOTE: FLAN HEty of Newport
KoF ES DUE each - AT TIME OF SUBMITTALL1
7V,'uilding F_ Grading F"Drainage KElec ech Plum Cu Yd nrt l
Project Address, (Not mailing addresso< food F- Fire [- Liq j- Landslide F -N/A Floor Suite No
Description of Work
Use Co stType
4Storiesl'A!T 0 units (if Res)r
r
New/Add SFF�a_RemodelSF yF �g `- GarageiNew/Addy
Valuation$ 4000
MaterialiLabor
OWNER'SNAME Last�'t`^- First
Owner's AddresOwner's E-mailEll Address
2-764 WKTeR° r1?4Ayr D Rl✓'_ S1.ckG�J1- Urs CIA e, N G . C4
City . _wi............. State_ Zip qZ(pZS7 Telephone
LICANT'S NA Last 'pAUTSC :t� First �'tf� W
Applicant's Address Applicant's E-mail Address
Z2�c�4\V�X(7E_F(2.e,irr AQtV2 S}1ck� PAu�[`sc 4 (WC .C—OR
city - State G. Zip p . .Telephone �'y O'�a. ��Q. .
F (. 4 . t c
RCHITECT/DESIGNER'S NgMELast Tk4 E'L First
.....__ Lic. No.
Architect/Designer's Address ArchftecUDesignefs E-mail Address
36eo�aiRrz+� Sure IZo_G ¢Q� rcz M
_ ..._..._.... __.....
Q
City .. .I. _.,.. .. .... ... State �-� Zip r Teiephon q`�QL 79-7-6-4
ENGINEER'S NA ME Last YA��+.i____ .� First SFIUCRI. (�{11G{.> LicNo• C43do5
Engineer's Address Engineer's E-mail Address
Iiz F. CAAPHAtJ ve , 'Sly -2 D - B�w�eata�� , coM
City 69AA&v State �� Zip C�a66� Telephone
_ _ _ . _ q/�
CONTRACTOR'S NAMEICOMPANY , 'g Lic No. —1 QassF
Contractor's Address Contractor's E-mail Address
City ( State Zip -I Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $
USE Z//
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