HomeMy WebLinkAboutX2018-0285 - Permit ApplicationC -Q-- O l
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Worksheet for Combo Building & Solar Permit Application
[- Comm'I {- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[—Building [-Grading [-Drainage [Elec [-Mech
[-Plum CuvdCut CuvdFill
Project Address (Not mailing address) Flood
[-Fire [- Liq [-Landslide [-N/ 4r Suite No
l`ice—
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Description of Work
Use F_ Const Type F_
# Stories # Units (if Res)s
S Eo2�
S -(2-t) u°
K')
$
New/Add SFF_ Remodel SF Garage/New/Add
Valuation
Material/Labor 5DL 2)�_
OWNER'S NAME Last L� 33 `5jpC3Ey_`1� LL(First
Owner's Address
Owner's E-mail Address
City X1..,1 Qom" -� G� State
,�j
ZipF'k��P(P� Telephone
APPLICANT'S NAME Last k Lis First t ��
Applicant's Address
Applicants E-mail Address
City YJEL,�jPC;2t- _ State I �.)'�l Zip��� C�1 Telephone / i
ARCHITECT/DESIGNER'S NAME Last c) � ��y
First —Lic. No.
Architect[Designets Address
Architect/Designer's E-mail Address
City C\�iN. �lt-LS State I Ly\ Zip q Telephonelgl()
_
ENGINEER'S NAME Last
Firsts Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City State Zip Tele a
CONTRACTOR'S NAME/COMPANY 1G�� C �� Lic. No. ClassF�
Contractor's Address
Contractor's E-mail Address
\ Ccs. $'zy�' l l b
- Q ?� Telephone
City 1`C—TJCiJ State _C_._ zip (3L� l 5 l,-ici5 �9,�
SETBACKS REAR SETBACKS FRONT
PERMIT NO. 001E -02 G�I p -
SETBACKS LEFT SETBACKS RIGHT
p
PLAN CHECK NO. Q a(��1l� -I 0
USE ZONE DEVELOPMENT NO
qaQ
PLAN CHECK FEES $ K 2V I 0 -0 Z's -5,
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