HomeMy WebLinkAboutX2018-3142 - Permit ApplicationCD2 -017 -0b I ?,M- 3@LQ,
Print,Form Worksheet for Combo Building & Solar Permit Applic
Comm'I Residential City of Newport Beach - Building Divisjon
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building ❑ Grading ❑Drainage Glee 'Me ch Klum CuvdCut F—I cued
Project Address (Not mailing address) ❑ Flood ❑ Fireiq ❑ Landslide ❑N/A Floor Suite No
154`1 E OceaJ 0 0
Description of Work 0 Use F7ConstType
AXv O 02
Stories #Units (if Res)❑
9 � Valuation
New/Add SF Remodel SF � L+� � Gara a/New/Add Material/Labor LW
OWNER'S NAME Last
Owner's Address
First
Owner's E-mail Address
City State Zip Telephone tLL. 7a -.-4�il1_--f J
APPLICANT'S NAME Last
Applicant's Address
Citynr_ T_ _ State
First
Applicant's E-mail Address
& CMa; . QoM
Zip �2,to, Telephone 58. �je . ig0'LI
ARCHITECT/DESIGNER'S NAME Last
►� I ER % =first Lic. No.
ArchitectlDesigner's Address
City I—Qatim State
Architect/Designer's E-mail Address C -2L1225
C'c'acchi�t^A ct- Cori
Zip 1� Telephone,) 2 Z
ENGINEER'S NAME Last G J�N� First NL%N Lic. No.j�8
Engineer's Address
?$80 Co�bLw
City �� a, ��. Stale _
Engineer's E-mail Address
Zip j,(0S7j Telephone /l ��J,O%%S
CONTRACTOR'S NAME/COMPANY _ Lic. No. Class 177
Contractor's Address Contractor's E-mail Address
City State Zip TelephoneF
7c2
SETBACKS REAR _0 �tQ11 SETBACKS FRONT 1 PERMIT NO.
J
SETBACKS LEFT �� SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT. NO -0 70 1 tl — DZ,6 ZPLAN CHECK. FEES $
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