HomeMy WebLinkAboutX2018-1592 - Permit ApplicationWorksheet for Combo Building &Solar Permit Application ��`°W,
City of Newport Beach - Building Division
r- Comm'I j `�tiesidential NOTE: PLAN C-HFCK FFFS DUE AT TIME OF SUBMITTAL G4�""'�
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Project Address (Not mailing address) C Flood
F_ Fire F Liq r Landslide F_N/A Floor Suite No
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Description of Work(�o� �FyvFp`( �r o
Use Const Type V_�
#Stories #Units (ifRes)F--
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Valuation$ �%� �Q
Material/Labor /
New/Add SF �lfrj '4 4-• Remodel SF Imo , f� Garage/New/Add F-
OWNER'S NAME Last GD L(i
- First I 'OgV lU _
Owner's Address
Owner's E-mail Address
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City /1,<lt-UPQ / State I ,-
Zip l-/•z�o6 Telephone, �j/-fc/--'�jSS�3�%%3
APPLICANT'S NAME Last aW 56e -j First C i�i vl
Applicant's Address
Applicants E-mail Address
City nom. �� .� /.j State �-
Zip - WU,6,3 Telephone
ARCHITECT/DESIGNER'S NAME Last i, �' 5GY"
First J S Lic. No. /:-317-7 131
Architect/Designer's Address
Architect/Designers E-mail Address
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City 1 N°•..�vPU�d'" tjp.�- State �j .
Zip 3 Telephone C(Lr�_&.,r
ENGINEER'S NAME Last i r/%--�1J�2
First Lic. No. �s�g
Engineers Address
Engineer's E-mail Address
City ,f *ri"�-7•f'TD- i�War_/5� I�-
Zip �2jpfj� Telephonei
CONTRACTOR'S NAME/COMPANY i
Lic No. Classr—
Contractor's Address
Contractors E-mail Address
City I -- - State �--
Zip 1 Telephone
SETBACKS REAR /61 1 SETBACKS FRONT
/7 PERMIT NO. C � 4��
SETBACKS LEFT ! SETBACKS RIGHT —
PLAN CHECK NO. ��j�% ,E
I USE ZONE —L I-' __ DEVELOPMENT NO
PLAWCHECK FEES '$ __.'