HomeMy WebLinkAboutX2016-2746 - Permit ApplicationPnnt FARC,, Worksheet for Combo Building & Solar Permit Application
QC]Comm'I E]Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[7]Building F] Grading ❑Drainage ❑Elec ❑Meth ❑Plum cuvdCut F7 cuvdFill l
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
53U 5 '8a ave.
Description of Work
Use Const Type 71
# Stories # Units (if Res)s
Valuation
New/Add SF Remodel SFGarage/New/Add
Material/Labor
OWNER'S NAME Last \Af 00 1 First Mr. aHd Rrs Larriq
Owner's Address Owner's E-mail Address
-
5305 84, ror + 11
CityW ,ele"c State Fav] Zip9 (o Telephone
APPLICANT'S NAME Last ,Aoill-ad First 4,
Applicant's Address Applicant's E-mail Addressis
o % C ISO Q ��k� C�77tA'SO VI (A OI n i�G✓IGS ..
City ,G, State (,!A- Zip Telephone�Z_ 8
ARCHITECT/DESIGNER'S NAME Last ��lit/VILI%br/� First( Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
co H1
City State �'„� Zip (Q Telephone'��C+-75.4/-y0 D
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address - Engineer's E-mail Address
City State d
Zip Telephone
,�
CONTRACTOR'S NAME/COMPANY itiGtS�OWr t b4jLS Lic.No. 88D21v(� Class
'"
Contractors Address Co,ntractors E-mail Address
1 �
(d7A DY. 6lG (Gtj'Dtime's a Gos,—,
City Nowphr,E- jeac(,t i State CA Zip 2- Telephone ggq_Z23_ IS a
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $