HomeMy WebLinkAboutX2018-2592 - Permit Application2017 -2582
Worksheet for Combo Building &;Solar Permit Application
CommT F Residential City of Newport Beach - Building Division 01.1NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F7, Building F_Grading-Drainage i—Elec j—Mech F- Plum CuvdCut cuvdFill F
Project Address (Not mailing address) f Flood r Fire (- Liq j— Landslide �N/A Floor Suite No
Description of Work Use F_ Const Type
� � t # Stories #Units (if Res)
Valuation
New/Add SFF--Remodel SF � Garage/New/Add Marerial/Laborllli �
OWNER'S NAME Last {/ First 2
Owner's Address / Owner's E-mail Address
City State I C .Zip F Telephone
APPLICANT'S NAME, Last (A First
'Applicant's: Address - Applicant's E-mail Address
:.A, CP t( 11` S` '� fb�l'e/e8P-05-4)r V falo'-11 n rf
Cdy � 7 State— Zip Zg(� (f Telephone 41ii e4.? �
r ARCHITECT/DESIGNER'S NAME Last First Lie. No. —
( ArchitecyDesignees Address Architect/Designer's'E-mail Address-----
City State �— Zip F Telephone
ENGINEER'S NAME Last First- Lic. No.1—
- Engineer's: Address Engineer's E-mail Address
City �— State Zip �! Telephoner
CONTRACTOR'S NAME/COMPANY Lic. No. 3 �jO&'s z Class 9
Contractor's Address Contractor's E-mail Address
City . Q� jPen� .p State zip i % 2� Telephone) %�'�� .� cj
/
SETBACKS REAR SETBACKS FRONT %4 PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
ClSEzt7Nl DEVELOPMENT NO PLAN CHECK'FEE&3