HomeMy WebLinkAboutX2018-2642 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o��EWFlo
j—, Comm'I F_� Residential
City of Newport Beach - Building Division '
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL CY[nORR'
F`IBuilding r Grading FIDrainage [—I Elec n Mech
[—I Plum Cu Yd Cut F
7__Cu Yd Fill F
Project Address (Not mailing address) ClFlood
rJ Fire (-1 Liq Landslide ON/A Floor Suite No
Description of Work
Use FB7 Const Type VW
# Storiesn # Units (if Res)F7
-3 C�JI 1 lJl/r ' -36
Valuation $
Material/Labor 3�
New/Add SF Remodel SF Garage/New/Add F_
OWNER'S NAME n�
Last �I.tAS First
Owner's Address Owner's E-mail Address
o IY _
EliIF �'
City 1, ] State �� Zip Telephone V
APPLICANT'S NAME Last �_ r C� First
Applicant's Address
Applicant's E-mail Address
\N - 1�00%'k j
\
�I
uy5d -can
c,�
City State � Zip
. t— -
`12 Z TelephoneF. q -,2031.�
(CHITECT/DESIGNER'S NAME Last First
- YA Lic. No. &�
Architect/Designer's Address
Architect/Designer's E-mail Add s
00 -
State Zip q ZOZ Telephone l k D ' I IZ
CityT s
ENGINEER'S NAME Last -
First' Lir�fllo.
Engineer's Address
Engineer'rL4tldres�g
City State Zip
[ Telephone M 'I Z L�
l/
CONTRACTOR'S NAME/COMPANY I h
Lic, No. 5 Class
Contractor's Address (�
It—OIO
City �(Y h" State [WZip
Contractor's E-mail Address
2�D Telephone 7) r1
V17,
pC-
SETBACKS REAR SETBACKS FRONT
PERMIT NO. r✓(,� a
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ , "%•