HomeMy WebLinkAboutX2017-3204 - Permit Application11 -
Work��4et for Combo Building & Solar Permit Ap I
icatio
City of Newport Beach - Building Division T7A1
F Comm'l �.Z_Resdential ( >< ) q07 1% �
J NOTE: PLAN CHECK FEES DUE AT TIME OF SUBRA
[—Building F_ Grading F—Drainage F_ Elec f— Mech plum Cu Yd Cut — Cu Yd Rl[
-IN F F
Project Address (Not mailing address) F_ Floo ire f— Liq ki-landslicle F_N/A Floor Suite No
V 2,S
Description of Work
Use Const Type
# Stories[ # Units (if Res)F
Valuation $
Material/Labor F65,oto
I F
New/Add SF Remodel SF
Garage/New/Add F_
OWNER'S NAME Last F
First
Owner's Address
Lucj
Owners E-mail Address
I city �� e,(� ev-A- State zip E �-2-� 7 Telephone
APPLICANT'S NAME L2St
Applicant's Address
First
ETddre
Applicants
city State
C zv�\
Zip 2 Telephone �qq Z�
ARCHITECTIDESIGNER'S NAME Last F�
First F_ Lic. No. F—
Architect/Designer's Address
F_
Architect/Designer's E-mail Address
F__�-
city F_ State F—ZiP
[ TelephoneF
ENGINEERS NAME Last
First Lic. No.
Engineers Address
Engineers E-mail Address
F3�q-7 �—D
City
le C)(�� 6(/r t - L_Ewy\�
PC) State
Zip Fzr&;-e�7� Telephone
CONTRACTOR'S NAMEXOMPANY Lic. No e�bl?
Contractor's Address
Contractors E-mail Address
H
city ct_�
State
v vv,(� �i (nfD v- n-ev-s4-o
Zip Telephone � r4 9 ;?----
A
SETBACKS REAR SETBACKS FRONT
PERMIT NO, Z_ e
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
��_i
USEZONE DEVELOPMENT NO
PLAN CHECK FEES $
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