HomeMy WebLinkAboutX2018-2287 - Permit Applicationistl zo�8 x2a n27
Print Form Worksheet for Combo Building & Solar Permit Application
F Comm'] KResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building (`Grading FDrainage 1�Elec Mech (`';Plum Cu Yd cuts '.. Cu yd Filll l
Project Address (Not mailing
address) f- Flood r Fire r', Liq r; Landslide FIN/A Floor Suite No
^515 _t,
6.01 9ayW - —'
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Description of Work
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Use Const TypeFvj/j_N..
L000
W
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# Stories! # Units (if Res)s
Am(w 1DLZ r � j syv\al �
�, iro�'>r1 �1t4 Ll. 0� 6,x 11'
_
Q _wA11
Valuation $ l
Material/Labor lO r 00
New/Add SFI�� Remodel
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SF Garage/New/Add
OWNER'S NAME Last
�.,.._.,� First y�
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Owner's Address
Owner's E-mail Address
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I c r eA f1 o u Iv- M Q l C,0 .
City ol
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State Zip — Telephoned
APPLICANT'S NAME Last
��I,� - First„
Applicant's Address
Applicant's E-mail Address J
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City 1 s��. p
State c4kZip F� Telephone 'l„I (j�L !' I
ARCHITECT/DE IGNER'S NAME
Last First F Lic. No. F
Architect/Designer's Address
Architect/Designer's E-mail Address
City _..
State �� Zip �— Telephone��
ENGINEER'S NAME Last
First Lic. No.1—'
Engineer's Address
Engineer's E-mail Address
City
State—,. Zip—, Telephone.
CONTRACTOR'S NAME/COMPANY
1 p _ I _ c I. Lic No.
7� ClassF
Contractor's Address
l
Contractor's E-mail Address
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City yyn ` ` rr State Zip C'I''�7 Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 1 I —2 -of
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $