HomeMy WebLinkAboutX2018-3884 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
I- Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
CI
F-Building (°Grading F-"Drainage (-Elec r-Mech
F-PlumCuvdCutCuvdFillF
Project Address (Not mailing address) F- Flood
r- Fire r- Liq (- Landslide FN/A Floor Suite No
I k00 c,r yi �
Description of Work
Use Const Type F
Stories # Units (if Res)7
'Valuation $
New/Add SF 0 Remodel SFr-- Garage/New/Add
I Q
Material/Labor 1 i OOO
OWNER'S NAME Last IYvf yw_ C-M�QYN�
1
First
Owner's Address
Owner's E-mail Address
S P_ W?oA a itr `br.
City I Z�2 CN� 11E�ec�tC�A State C�
Zip �2(ac() Telephone[ �%'`{q q-72�-3210
APPLICANT'S NAME Last! PeI/zZ
First( 1 V-P_Yl
Applicant's Address
Applicant's E-mail Address �.
3`�S B. (r�Y� L�i7r.
rer�.0(c-77 @ aLtOo
city r S State I CA
Zip 2�-2 Telephone -T(I— o"
- 1
ARCHITECT/DESIGNER'S NAME Last �ob n��
First; Chi l Lic. No. j
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
� �� •
Yd JIYl�=�06�� Yv�q(11C• r'1��
City �I � a L .�Sa State
1�
Zip q (p2 / Telephone! -I 1 rj
UO
E�il
ENGINEER'S NAME Last F
First Lic No.F_P
Engineer's Address
Engineer's E-mail Address
City � State �®
Zip Telephones
CONTRACTOR'S NAME/COMPANY n e , ry �l1y,(- S Lic. No. FE4 t�i 7 ClassF(i
7 1�
Contractor's Address
Contractor's E-mail Address
City State , �I
Zip cr'yG(-3 Telephone 1�� 3' ib'36`(
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $