HomeMy WebLinkAboutX2018-0246 - Permit Application� X2fll�'D�-'k10
Worksheet for Combo Building & Solar Permit Application onle
City of Newport Beach - Building Division
r Comm'I /Residential
"� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
PBuilding r Grading F -Drainage r�V Elec PMech ' [p Plum cu yd cut cuvdFill
Project Address (Not mailing address) ( Flood' F_ Fire Liq r Landslide F_N/A Floor j Suite No
Description of Work Use $ Const Type v
noa 6z-, I< I i T2> t--�t J �
I #Stories #Units (if Res)
-- Valuation $
New/Add SF 143 Remodel SF b-74>Garage/New/Add r �^ Material/labor
OWNER'S `NAME Last `{ First�LilL'
`Owner's Address Owners E-mail Address
xxg
CityT` State ..Zip q - TelephoneFl IN - Fo32 - IZ�
IF 'v�
APPLICANT'S NAME Last r�G� First
,Applicant's Adddress/ Applicants E-mail Address
71'792-
.City , State � - Zip -. Z�:b,S� Telephone -.4-41-74
ARCHITECT/DESIGNER'S'NAME Last �G� �L� First 5p Lic. No. �—
'.�Architect/DesignersAddress Architect/Designers'E=mail Address -
City— State �— Zip �— Telephone—
. .,.
First
ENGINEER'S NAME Last )
'tF'-7 Lic. No.
Engineers Address Engineers E-mail Address
City State Zip q 2 ' Telephone l l i -k S56 ..Z_XS
CONTRACTOR'S NAME/COMPANY M F} ; L l i:::Wa \`G-OSTMIkic. No. 1 d l 6 J o Class
Contractors Address Contractors E-mail Address
2�u1gL�t c��%=INI a dei . V1e"r�tat
City -�✓t G I State e /{ • Zi QITelephon c� LF� -r-L91 -(d�� -
SETBACKS REAR S r Ttel� SETBACKS FRONT S (1M4fiD� PERMIT NO.OZ�Z (/"t
�YgA
SETBACKS LEFT — SETBACKS RIGHT ?� PLAN CHECK NO. t%_ 0s+io
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