HomeMy WebLinkAboutX2018-3393 - Permit Applicationr Worksheet for Combo Building & SolartW
A12 W
F- Comm'[ P7_' Residential City of Newport Beach - Building Division oGaop
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Jj(Building F_ Grading rDrainage KEIec 15ZMech
PZPlum cu Yd cutF Cu Yd Fills
Project Address (Not mailing address) F_ Flood r` Fire F- Liq [_ Landslide [N/A Floor Suite No
22_0'1 WCA2r,�-N P JW
0"Z�_ Ga CA -
Description of Work
Use s— Const Type
'T cl �
# Stories # Units (if Res)F—
Valuation $ �
�
New/Add SFFIF
Remodel S
I Garage/New/Add
Material/Lab,r ,
OWNER'S NAME La
First IQ�
Owner's Address
Owner's E-mail Address
2Z04WArruf-F ®IJ — fL
—State (v P,
City FE
Zip 5? (�� Telephone 4k7 )-- 00PO
APPLICANT'S iNAMELast �� �� �
Firstl --!T(5
Applicant's Address
Applicant's E-mail Address
7.-2-0 �fe j::-eoNrr jb C_
(zeb, NC� a c
City State
cb c
Zip Telephone
E+1?64'%�--�Q
ARCHITECT/DESIGNER'S NAME Last FY
First
Architect/Designer's Address
Architect/Designer's E-mail Address ( �g • G»
City ® �— State �
�
Zip s—s Telephones--
ENGINEER'S NAME Last �
First I --i Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City State F_
Zip �-- Telephone—
CONTRACTOR'S NAME/COMPANY QC#
( - " �C Lic No. Class �—
Ctr is ddresp
Con' tor's -mail A d ess
ZQ W
G.
C G
Zi �q 'I ele and
i
SETBACKS REAR SETBACKS FRONT
S TBACKS LEFT SETBACKS RIGHT
!!!:;,PL N CHECK NO.
-
SE ZONE DEVELOPMENT NO
- PLAN CHECK FEES-$-