HomeMy WebLinkAboutX2016-1017 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application a�
City of Newport Beach - Building Division A
r Comm'I (- Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j`Building r- Grading F -Drainage, [Elec j-Mech j -'Plum CU Yd cut) Cu Yd Fill
Project Address (Not address) C Flood [ Fire r Liq j- Landslide I -N/A Floor Suite No
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Description of Work
Use Const Type F
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kStoriesrJs'Units (if Res)F—
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Val $
New/AddSFF Remodel SFr_— Garage/New/Addy--
uation
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OWNER'S NAME Last 9-+A U�Q <� First
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Owner's Address Owner's E-mail Address
City � - _.. _ _ State �— Zip F— Telephoned.
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APPLICANT'S NAME Last57 fIZa _ _. _ First , A17—i�0,4/1
Applicant's Address Applicant's E-mail Address
za P ,1,1P1Z9k 1,4tF, 4a rnu i -s'.
City _ __ _ _...,. State I- Zip Telephoned
ARCHITECT/DESIGNER'S NAME Last _ First Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
City � State F_ Zip F_ TelephonedENGINEER'SNAME
Last First 5" ,E% z c) i Lic. No.F—
_11
IsFX320
Engineer's Address Engineers E-mail Address
City �' aWW _.. %<1401V _ _ State �� Zip �Z41`�.( Telephone W L ,-7Z,-0)-7-,7_
CONTRACTOR'S NAME/COMPANY Lic. No. �T T' Class..
Contractor's Address Contractor's E-mail Address
City r-� State--- Zip,' Telephone)---
SETBACKS REAR SETBACKS FRONT PERMIT NO. :'2
SETBACKS LEFT SETBACKS RIGHT PPLAN CHECK NO. 1
I
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
CITY OF NE_ VPI ORT 1BEAciI