HomeMy WebLinkAboutX2018-3835 - Permit ApplicationA60 .2018
-z;-73 0 x2019.3835
Print For ;;q Worksheet for Combo Building & Solar Permit Application
❑ Comm'I ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building E] Grading ❑Drainage ❑Elec ❑Mech ❑Plum CuvdcutF__� CuvdFinF_
of Work
New/AddSF�
OWNER'S NAME
!iling address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
a 5 ds'e " Const
q NOb cd # Stories' # Units (if Res)m
s� Z
Valuation $ ,rt
Remodel SF� Garage/New/Add Material/Labor 7 ( V 0
Last
Owner's Address
City F// � /),<(, C7v ::,7 o
APPLICANT'S NAME Last
Address
City State
Owner's
Zip
First
Applicant's E-mail Address
Zip [77:7 Telephone)
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
City F— State
Architect/Designer's E-mail Address
Zip Telephoned
ENGINEER'S NAME Last I First Lic. No.�
Engineer's Address
City 7 State
Engineer's E-mail Address
Zip Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. C7 Class
Contractor's Address
City �— _ State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
Contractor's E-mail Address
Zip Telephone��
PERMIT NO. V1,0 t $ — 3 835
PLAN CHECK NO. Zc( b 0 - zo l n
USE ZONE DEVELOPMENT NO V' D 1 Q — O �JPLAN CHECK FEES $