HomeMy WebLinkAboutX2017-0240 - Permit ApplicationXMI- NAO
Work_s4et for Combo Building & Solar Permit Application
(— Comm" F4 -.-K �'/� \) City of Newport Beach - Building Division o
NOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r�uilding F -Grading rainage [—Elec F_Mech Plum Cuvdcuts, CuvdFill F_
Project Address (Not mailing address) F_ Flood r Fire r Liq F_ Landslide GN/A Floor Suite No
� J
'2Sia t Ct.�Le� � st'
Description of W
Const Type 77
f
#Sto- #Units (if Res
ries)7,
.
` ��
Valuation $
� �Gara e/New/Add —
New/AddSF� Remodel SF 9
Material/Labor � `lt
OWNER'S NAME Last First
Address
Owner's Owner's E-mail Address
2Rol cAeo6 e r - ,
City Lpe%-.1imv ezo State C...�c ..,, Zip Telephone f
APPLICANT'S NAME Last kCJ1zZ First I LOES
Applicant's Address Applicant's E-mail Address
^
PRS �liCl�.. ST—_._ ___. —_.. _� Cotf;,,��<OQ-U� ��t�"•CCA� _... _._:
city L i�'L"-�¢�F: State Lam ,... Zip Ct bkC�... Telephone q5C "f.`a--S?_4
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
r--
--
City State F Zip F Telephoned -,
ENGINEER'S NAME Last I First——Lic. No.
Engineers Address Engineer's E-mail Address
City State F_ Zip F Telephoner ---
CONTRACTOR'S NAME/COMPANY Lic. No. QW" Class "
Contractor's Address Contractor's E-mail Address
i�3R5 Dotarc �� _ �ttFgh�}�l�l �;,[}tkxa.C,oW�
City Ny, ��p=., --._ State ar � .. Zip Q Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT `PLAN CHECK NO.
I tPLAN
USE ZONE DEVELOPMENT NO CHECK FEES $