HomeMy WebLinkAboutX2018-2957 - Permit Application (2)Worksheet for Combo Building & Solar Permit Application ��eW
City of Newport Beach Building Division n
(- comm" Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 4.oa•"
17 ,wilding j- Grading Drainage � Elec r-Mech j-- Plum - CUYd�C-ut �' C�vdrill
Project Address (Not mailing address) Flood j Fire F-, Liq r Landslide [N/A, Floor Suite No
Descnptton of Work Use. Const Type '
Stories _# Units (if Res),
Valustioh$'
New/Add SF 7J �� Remodel SF1' O Ganga/New/Add Material/Labor
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OWNER's,NAME" Last�C'
First gfNlh/{(},i�tT�Gi'c� l C,L6'r/Q4co
,Owner's Address: Owner'sEmiql'Atldesr;''
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City
, /�/Iv'/rJ '�Ct'A%r State �- Zip PO` Tale pfiorie ' W13 Q�
APPLICANT's;NAME Last
First,
Applicant's Atldress Applicant's E-mail Address
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City State ZiP Telephone
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ARCHITECT/DESIGNER'S`NAME Last F irstr �F .
Lic. No.
' ArchiteotiDeeigner's Address > Architect/Designeft E-mail Address
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State F— Zip F777Telephone
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ENGINEERS NAME Lead - First< - : =Lic. No,1
Engineer's-Address aEnglneeesr'E-mail Address