HomeMy WebLinkAboutX2018-3386 - Permit Applicationj'7l3 (��15N Jit -1 e/j4iT) z6R"019
X2013- 3386
Print Form . Worksheet for Combo Building & Solar Permit Application
F! Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) rI Flood r Fire r Liq [-I Landslide rN/A Floor Suite No
Description of WoX "" `{ � �L
Use F—! Const Type
aN�AkO 1140A
# Stories; #Units (if Res)
Valuation $
e Add SFF Remodel SFF Garage/New/Add F f Material/Labor
OWNER'S NAME Last
Owner's Address
Owner's E-mail Address
M INNO V f770/V 11��.
City �QV/'V-U State Zip _9__ 2--Z Telephon i?W 7zp—, ¢g
APPLICANT'S NAME Lastmfl-✓r_
Applicant's Address
73/ 1Y, MAiy sT_
City �/'7T�`!. - --- State CA- Zip
T Last /
Architect/Designer's Address 7�EuiWAR-1-1 AVC.
73/__IV/La T _
City State
First
E-mail Address
Telephone //3, `�iZgJ
FirstF Lic.No.
Architect/Designer's E-mail Address
Zip- Telephone
ENGINEER'S NAME Last ®/7i/q! First F Lic. No. CS9D.ZZ
Engineer's Address Engineer's E-mail Address
1&*). / Y, 02 0 SCS p �p
City .tom/'� State !lam/ Zip /�rJ78Q Telephon �6� ` z^ 1��7eO
CONTRACTOR'S NAME/COMPANY
i
Contractor's Address Contractor's E-mail Address
731 /z� M4�v 5r.�i%83�7• �wr
City �_ ._. -.�i State Zip ,z RE TeI pho
SETBACKS REAR SETBACKS FRONT PERMIT NO. ;Kzot,Q) ^ �7�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. •, ! 67-f7 o
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ I I