HomeMy WebLinkAboutX2017-3822 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division Y11,017-
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Project Address (Not mailing address) C Flood r- Fire F_ Liq F_ Landslide CN/A Floor Suite No
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Use Const Type
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Valuation Hry/}
Material/Labor
New/AddSFF—
Remodel SF�— Garage/New/Add—,
OWNER'SNAME Last First 16omc/3
Owner'sAddress
Owner's E-mail Address
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APPLICANT'S NAME
Last aC.4 - First
Applicant's Address
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Applicant's E`ail Addrs
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ARCHITECT/DESIGNER'S NAME Last First— Lic. No.
Architect/Designees Address
Architect(Designers E-mail Address %p
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City
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State F— Zip F—. Telephone
ENGINEER'S NAME
Last First �— Lic. NoT—
Engineer's Address
Engineer's E-mail Address
City
State Zip F— Telephoner—
CONTRACTOR'S NAME/COMPANY i�lo�/QI(` r, Lic. No. C��6`�Z0 Class�—
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Contractor's Address
Contractor's E-mail Address
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Zip 42S;l Telephone q t (' , 7 j( f
State710
SETBACKS REAR
SETBACKS FRONT PERMIT NO. jb rl
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ �(�