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HomeMy WebLinkAboutX2018-0836 - Permit ApplicationX2.olG - Iq (q 5 + c)q V i ok Pcle_itwo Worksheet for Combo Building & Solar Permit Application GPI Cityof Newport Beach - Building Division (—.Comm'I Residential ninTG. of nnI ruGric FFFS nl IFAT TIME OF SURMITTAL ' a wilding �rading [—Drainage �Elec �i6w h , �Plu uvdcut� Cu Yd Project Address (Not mailing ad"dress) F. Flood F Fir Liq Landslide �N/A Floor Suite No d l Description of Work Use ��ConstType F #stories%' # Units (if Res) i' Q` © v � 1�,60 2 ��l� c J w P►�Posu'b wb S- Valuation $ Material/Labor - New/Add SF 2 Q L Remodel SF Garage/New/Add �&a OUIINER'S N"AJMEIf'/ I Last G�� First J® �t^R Owners Address Owner's E-mail Address lD � .tteCity Zip 75 Telephone71•./Z.` APPLICANT'S NAME Last First Applicants Address Applicant's E-mail Address `City •, 'State �— Zip Telephone— ARCHITECT/DESIGNER'S NAME Last" OT57first�`� Lic No. F— ArchiteettDesignerr ss Address ArchitectlDesignees-E-mail Address �o(IICo�P..���'. ��Ij h �S o � r ✓� �L., �2Lip I c (Y Telephone J"rs l¢'s> 6(p fj City N"Old � K_/+ _ V76'4c`- 4 State �2p Z ENGINEER'S NAME Last Jk t T First S Lic. No. C' 6SZ557 `I t � Engm`eers Address Engineer's E-mail Address t� 8o b ( Ar 4LIZ4tlCA- Y�ZSD sy a�eh q@ S c ; © or v►k . c q4 )V�94_0City �,�State Zip elephon1e CONTRACTOR'S NAME/COMPANY Lic. No. Class' Contractor's Address.. - , Contractors E-mail Address i ity - _ State Zip �� Telephoned; BACKS -REAR _ SETBACKS FRONT ACKS LEFT SETBACKS RIGHT :- nFVFI. nPMFNT NO _.PERMIT NO. 21 6yy�� PLAN CHECK NO. `LNL-� /PLAN CHECK FEES $