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HomeMy WebLinkAboutX2018-2047 - Permit ApplicationX"171?O�f� 1,605-,2048 ,i,1r L1 - Print Form Worksheet for Combo Building & Solar Permit Application r Comm I Residential City of Newport Beach - Building Division /1 j�/� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI*A o)/� W 1 r•(GKiJ wilding Grading [—Drainage rElec [-Meth [—Plum CuvdCut 4147Cu Yd Fill Project Address (Not mailing address) r Flood r Fire r Liq r Landslide G Floor Suite No 4IC) Ibis�Nvo,c",-L)M,C,-N9228 f— Description of Work �j Const Type Use I •f �m^,.� �-,��� '/� �- Y'� V Cl 2 SF � t�tii�1�(, w # StoriesT # Units (if Res)F- 3 �Y- Valuation $ s / 0�• A .•,�- Material/Labor NJ Uj `it/ New/Add SF �j emodel SF Garage/New/Add � i OWNER'S NAME Last vct- FWt"�&irstFL b Owner's Address Owner's E-mail Address Zoj�_n��Sat-itO 1 I, N City �f �/Y `r' v ' rvU'� _',, State 7 Zip CJ 6rj© I Telephone _. . y APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address 14_7d W� Ot��trda��hit�c, i t �e City IAV l\E __._ State Zip. �Z�Jj� Telephone O.... 20i2 -Z33 -A ARCHITECT/DESIGNER'S NAME Last `/ �,� First Lic. No. G • Cl 06 1 Architect/Designer's Address Architect/Designer's E-mail Address +70 V, A-1 \0 �G C lGt.l rJrdo.�c�1� , pec i I re c i City V j _ • State FET -Zip ��6 ��.. Telephone (,q+ei1 4-'5-7,-_qg�q�5 ENGINEER'S NAME Last "F First f,5TWE" L, Lic. N Address Engineer's E-mail Address T•� �� Engineer's 7D WA1,0 Zip CJ Z�10 Telephone -7 It)P�2Od ' OZ&C) City Iw L_state CONTRACTOR'S NAME/COMPANY I /T �j h� Lic. No. ��J j •��� Class' 1(/ i 'J Contractor's Address Contractor's E-mail Address./ t f �►1C�(1%44 AVL/ E v FIS fZ C YA�Z1f3l City `i/.(ti, ,16FSA State 1� .. Zip �°z( Telephone Zq_�-a�j -4�J6O SETBACKS REAR SETBACKS FRONT PERMIT NO. / \� la • ��-Y1 jZp� k LEFT SETBACKS RIGHT p PLAN CHECK NO.— ILpS: 2�l p,`� E DEVELOPMENT NO - 1:0' PLAN CHECK FEES $