HomeMy WebLinkAboutX2016-2765 - Permit Applicationx2-01 LP - 2,-1 LPs
r et for Combo Building & Solar Permit Application
[7Comm'I r7Residenti I D City of Newport Beach - Building Division a d
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) ❑ Flood ❑ Fire iq ❑ Landslide ❑N/A Floor Suite No
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OWNER'S NAME Last C r-oS s L�Y First Py E .'j'
Owner's Address�
Owners E-mail Address
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City I JJll e-- 8 eVrt t-1 I State G Pc Zip 9 i.6 e3 Telephone `{ 01-6- 0&
APPLICANT'S NAME Last 14 AVA PJA-114 G (-t I First I M/C T
Applicant's Address Applicant's E-mail Address
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City LA GtA ivA JVl6 vt EL State ® Zip Telephone 1-77
ARCHITECT/DESIGNER'S NAME Last First D
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City I State E-771 Zip Telephoned
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address Engineer's E-mail Address
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City State Zip Telephoned
CONTRACTOR'S NAME/COMPANY h eti N ST. I Lic. No. '7661 g Class
Contractor's Address Contractor's E-mail Address
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City I 1A bu "A 0% G N ol, ! State C /E Zip Telephone qyg Sap �N77
SETBACKS REAR �I/ SETBACKS FRONT 4-1 NO.
SETBACKS LEFT 31 SETBACKS RIGHT '31 PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $