HomeMy WebLinkAboutX2018-0984 - Permit Applicationx %O 11170 -0C`1$` -r
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
7 Comm'I i Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building 1 Grading F -Drainage F_ Elec r Mech F- Plum Cu Yd Cut Cu Yd Fill F_
Project Address (Not mailing address) 1- Flood Fire r Liq 1 Landslide rN/A Floor Suite No
/ u Oc� Cove
Description of Work
Use Const Type
# StoriesF— # Units (if Res)
Valuation S I j �o
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New/Add SF I Remodel SF
Garage/New/Add F_Material/Labor
OWNER'S NAME Last tJl(��A�1-jV
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First o�
Owner's Address
Owner's E-mail Address
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qty l_ �\� � . ,'��,` State -_
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Zip IZj,L `" Telephone�"l l TTi ✓'Y� 1. -T
APPLICANT'S NAME Last I V `� 11 First V ��
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Applicant's Address _
Applicants E-mail Address J
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City -\� State F—
Zip l i Telephonel��ilf'✓Y�
ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. (--
1
ArchiteaUDesigners Address
rch t/Designer's E-mail Address
City \ State I
Zip TelephoneF—
ENGINEER'S NAME Last
First �— Lic. No.7
Engineers Address
Engineer's E-mail Address
City State I
Zip ! Telephone
CONTRACTOR'S NAME/COMPANY�
Lic. No. I ,boqu OClass
Contractors Address
Contractor's E-mail Address
-boo W ) R
City f f'C�Uv State F—
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Zip -j Telephone) Z
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
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PLAN CHECK NO. D 7 �'7 - Z o f o
USE ZONE... _ _`-... _ .. _. DEVELOPNtENT NO -..
- _- PLAN CHECK FEES $ ' .. -..-- )�P-......