HomeMy WebLinkAboutX2018-2048 - Permit Applicationx=5 --X49 1606-901-3
Print Form Worksheet for Combo Building & Solar Permit Application
F— Comm'IResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Auilding Grading rDrainage rElec rMech r— Plum cu Yd cutF Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire r Liq j-; Landslide rN/A Floor Suite No
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Description of Work
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Use I •�
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#Stories #Units (ifRes)�'
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New/Adc Remodel SF� Garage/New/Ad
Valuation $ 1 1
Material/Labor
OWNER'S NAME Last rTPIhAA( f_
Owner's Address Owner's E-mail Address
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City F_ r�G+ �u'r r State I. ter` ZiP CiZ6&Q ' Telephoned
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City _ State r Zip Telephone q i-q)2�I Z - 233"1
ARCHITECT/DESIGNER'S NAME � 1,�//i� 4�0�,E� gg Lic. No.� C1 06
Last './�t�__---..... Firstl
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Architect/Designer's Address Architect/Designer's E-mail Address
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city State Zipq 7.(o tTelephone(ffzYj3_gg1)r
ENGINEER'S NAME Last Firstf,5iA1)_Wi. Lic.No.Co,
Engineers Engineer's E-mail Address
�Address
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City _ State Zip CjZro10 Telephone I`7 w- �Z&0
CONTRACTOR'S NAME/COMPANY'tom Lic. No. Class T i3
iJ
Contractor's Address Contractor's E-mail Address
City F State F Zip TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $