HomeMy WebLinkAboutX2018-3810 - Permit ApplicationWorksheet for Combo Building & Solar Permit Appi ion
❑ Comm'I ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building [7 Grading ❑Drainage ❑Elec ❑Meth ❑Plum Cu Yd Cut I Cu Yd Fill
Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
2 A nP .lin-e AN I 0 0
Description of Work
INo,,J -7
New/AddSFI:777 Remodel SF 7_771 Garage/New/Add hI
71
Use F7 Const Type f.�5
# Stories7l # Units (if Res)F
Valuation$ 3cipGb
Material/Labor �7J
OWNER'S NAME Last., First I
�- i � l/1 LY
Owner's Address
Owner's E-mail Address
City N.e �� P1JL - State Zip q Z� (E+ Telephone��
APPLICANT'S NAME Last
Applicant's Address
I Ci
City �c�r.�r i{'L. '�6/'�� State ['cz
First 1 11 r]," c
Applicant's E-mail Address
aam el er) d r-czC �es fg . cUry)
ZipIU7d� Telephone Zq% ('`(ram
ARCHITECT/DESIGNER'S NAME Last[
r� First ti Lic. No.
Architect/Designer's Address
f
City I State
Architect/Designer's E-mail Address
Zip Telephoned
ENGINEER'S NAME Last ` C, S C r\ I First M �( (,U S Lic.
Engineer's Address
City State
Engineer's E-mail Address
Zip Telephone
CONTRACTOR'S NAME/COMPANYLic. No. �Qjj I d Class
, ��
Contractor's Address
City _ C f1..�-cam .A-/\ C; _ J State
Contractor's E-mail Address
Zip 777_5 TelephoneF-----�I
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
.g$I®
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
%,7,01$
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $
1 D > 0057