HomeMy WebLinkAboutX2018-0225 - Permit ApplicationX 20 t� ' O ZZ5
Worksheet for Combo Building & Solar Permit Application
F_ Comm'I XResidential City of Newport Beach - Building,Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL OF
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Building Grading
[`Drainage" 41ec Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood F- Fire F` Liq r- Landslide rN/A Floor Suite No
57 AAfeC r. fio
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Description of Work
Use F-7—, Const Type � "
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42
# Stories # Units (if Ress
uion $
Valat"
Material/Labor yob ODD
New/Add SF�—
Remodel SF Garage/New/Add �—
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City
State '.Zip I Telephoner
APPLICANTS NAME
Last Q �_j p Z First
Applicant's Address
Applicarifs E-mail Address
ll57y FoDrt-e{pl-1 way ma�7ogme czo.cow
City �., PPCO.. r- S
_ State ZiP l2-5 / / Telephone ,KI _3/
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ARCHITEcrtDESIGNER'S NAME Last First �— Lic. No. F—
Architect/Designer's Address
Architect/Designer'scE-mail Address
ity
State— Zip F— Telephonel—
INEER'S NAME
Last First — Lic. No.F —
ear's Address
Engineer's E-mail Address
State �— Zip �— Telephoner
CT NAME/COMPANY Lic. No. �QZZZ Class
1? ocih I
Address
Contractor's E-mail Address
1--9-2-!r-7 / Telephon5�—
SETBACKS FRONT PERMIT NO. W r Z
SETBACKS RIGHT PLAN CHECK NO.