HomeMy WebLinkAboutX2016-2447 - Permit ApplicationXZDI 1P -ZN Nara cel j o, (9 �(�Q.� —,
Worksheet for Combo Building & Solar Permit Application � °
9 pp �''� qe
❑ Comm'I esidential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `�.,,a„,.,.
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Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide WA Floor Suite No
Description of Work
Use Const Type
# StoriesE] # Units (if Res)❑
N(�
Valuation $
Material/Labor
New/Add SF _ Remodel SF� Garage/New/Add �
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
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City State ® Zip I !il -/ 4i / S Telephone 327
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APPLICANT'S NAME Last N, C First A
Applicant's Address Applicant's E-mail Address
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City L./ State EWzip Z� Telephoneyq
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ARCHITECT/DESIGNER'S NAME Last oi.J�P,PP LC i First G;;7 �J Lic. No. _
Architect/Designer's.Address Architect/Designees E-mail Address
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City ��-•�4a4 State Zip �Telephone
ENGINEER'S NAME Last First ��, ' . No.
Engineer's Address Engineer's E-mail Address
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City I (�^�,Einj State Zip 2 Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
City j State Zip Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N6. `-
USE ZONE DEVELOPMENT NO�, —%)��� PLAN CHECK FEES $
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