HomeMy WebLinkAboutX2017-1667 - Permit Applicationamu%i&07
Print Form ' Works ee for Combo Building & Solar Permit Application (g®r,
Comm'I Residential city ofNewport Beach - Building Division NOT NAN CHECK FEE§,NE AT TIME OF SUBMITTAL
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Project AddrCBs (N0 ailing a CSS) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide N/A Floor Suite No
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Description of Work
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Use [VTConstType FV
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# Stories # Units (if Res)
Valuation $ j
Material/Labor GQ (y
New/Add SF L 2 O Remodel SF 2 Z O Garage/New/Add
OWNER'S NAME Last �erG��C�_ First �ClTi
Owners Address Owner's E-mail Address
City State F_7� Zip � Telephone � � 4 � % Z� . g D
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
PC A p r m sm iyl- d- wales
City SAoi E,c/
Ger-fuiE:77. State FE FV1 Zip � Telephone
�Lic.
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ARCHITECT/DE Lash���� V� First No.
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Architect/Designers Address Architect/Designers E-mail Address
City State Zip Telephoned
ENGINEER'S NAME Last .T First per/ Llc.�.l/-
Engineer's Address Engineer's E-mail Address
City �ri� State C� Zip C)� Telephone _ 2 •� Zl�
CONTRACTOR'S NAME/COMPANY Lic. No. D I a ( Class
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Contractor's Address Contractor's E-mail Address
City/ _. State Zip Telephon (�}
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS L SETBACKS RIGHT PLAN CHECK NO. o
USE ZON DEVELOPMENT NO PLAN CHECK FEES $
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