HomeMy WebLinkAboutX2018-2746 - Permit Applicationfto - 0� 16
TWor,'kshoet for Combo Building &polar Permit Application
F COmm'I fv`eResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
�gW POD
ore
Cq<iFOR��P
uildin i Gradin
�1 g g f Drainage (''Elec_ ech -f Plum cuvdcuti CuvdFill
l
Prodect Address (Not mailing address) IF Flood F Fire F_ Liq i_ Landslide ? N/A Floor Suite No
04
Description of Work
F---_
Use ; Const Type
r-�
t�+t= eXk0 _D i T� f�c �kS'f 'Lt��^✓� f iT
# Stories: tr unit5;if e5)I
Valuation $ jo j
Material Labor
_ - -
New/Add SF; (Remodel SF V�o Garage/New/Add w
OWNER'S NAME Last L�!,� First `^
Owner's Address Owner's E-mail Address
-2 V
City N�iitl PD/�T- �rG� / State Zip — Telephone
T
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
• i
City --_ Y— State � Zip i Telephone— -
ARCHITECT/DESIGNER'S NAME Last � � First � r � Lic. No.
Architect/Designer's Address Architect/Designees E-mail Address
S� o -3?u/&r,,j _ f2�� (04jL �/� S�S�c�esl,�I �, ���c � Cof�1
City State� zip Telephone
c1Zl* z_7S — '7
ENGINEER'S NAME Last HAK I � First W Lic. No.k-
Engineer's Address Engineer's E-mail Address
f 4DY 144i(tw( C t W(4Ek-I1JEY-jA)6-, e-0 *1
City �,/:N State Zip q Z(C' Telephone/eklr{� goo
CONTRACTOR'SNAIVEXOMPANY A �I C01q � �C��� Lic. No 11 Classll
vV
Contractor's Address Contractor's E-mail Address
oo A6yag�(-- 36(✓o .Still re
City State Zip �� Z�/� 2 Telephone,( iol) 6 J ? — ?7 l '
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
I -