HomeMy WebLinkAboutX2018-0553 - Permit Application (2)Worksheet for Combo Building & Solar Permit ApplicgSation
I- COmm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT THE OF SUBMITTAL x �a" _�
7-Building j Grading F-Drainage e h lum F—
ect Address
of Work
New/Add SFI -Tr-.,,
Cu fd Cut1 Cu Yd Fill I
(Not mailing address) F_ Flood r Fire �L y 7 Landslide FN/A Flllloor
ia--
Remodel SF S Garage/New/Add I
OWNER'S NAME Last
First I � 1-10 L,
Suite No
Use ConstType
# Stories, r� # Units (if Res)r—
q f /5CV
Owners Address - -
7-0"15 OwnersE-mailAddress
(City _ State 1i//4 ZIP 4i (B 0 (�—
P I � 6 Telephone,
APPLICANT'S NAME Last i--
�
Applicant's Address
6gOl Gttt Cs, (, Z7
city I 's-I - Vz, .
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
1 Td 1 _ Q L4/M t.' 4-T
city 1 ra Rr
First I
Applicant's E-mail Address
FilLt /� t• t Ci v_1 L I a I t i. t-1 Ir T
State —
e�i4 ZAP 1, � Z -(o(Q4 Telephones q go, ,7,4
Last 1 y,JOpC,
State
ENGINEER'S NAME Last i M N le- 14 1 Av
Engineer's Address
I � I �- -r 5
®®&'
State ljrC.-
I
First (� �I 6., �j Lic. No. 2 Z
Architect/Designer's E-mail Address
F5tz-IA-1-0 l/-j
Zips iZ �� Telephoners /7-3pLz,
First Lic. No.i 4 CD
Engineers E-mail Address
Zip Z I Telephonel &14M 41,1 &7,"
CONTRACTOR'S NAME/COMPANY
�
LicNo.
Class)
Contractor's Address
Contractor's E-mail Address
C4
State �
Zip � Telephoned--
G)o0
�� 1
SETBACKS REAR ' d I
SETBACKS FRONT
I Ci 1 PERMIT NO. B (�
SETBACKS LEFT
SETBACKS RIGHT
t PLAN CHECK NO.
''
//N S 't
USE ZONE
_._
DEVELOPMENT NO
PLAN CHECK FEES
1 57 ,,