HomeMy WebLinkAboutx2018-3378 - Permit Application (2)20 is -_' ✓31 F
Worksheet for Combo Building & Solar Permit Application�';J
F_ Comm'I j Residential City of Newport Beach - Building Division o a ''_
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `'•oa^'
j Building F_Grading F -Drainage F_Elec F-Mech F- Plum cuvdCutr Cu rd Fin
P/dr je tAddress (Not mailing address) F- Flood F Fire [- Liq F_ Landslide F_N/A Floor Suite No
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Description of Work
Use Const Type �—
# stories, # Units (if Res)7
Valuation $ Cf
Material/Labor, t
Remodel SF
Garage/New/Add
New/AddSFI
OWNER'SNAME Last,
)PjgEer First!
Owner's Address '�� Jy,✓^
�,� ff,.tOwner's E-mail Address
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City I C; f .s State •`.: Zip�ij % 7/, Telephoner
APPLICANT'S NAME Last 1 ,C Cxvo. ✓r's ' C�" First! 70 7 TZ -
Applicant's Address
i
Applicant's E-mail Address
City /l G. .State
Zip �... ) Telephone' `e71"1- �. C=�•"�
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ARCHITECT/DESIGNER'S NAME Last
First F_0 Lic. No, �—
Architect/Designer's.Address
Architect/Designer's E-mail Address
City I _ State—.
Zip Telephoned s�-
ENGINEER'S NAME Last i
First Lic. No f
Engineer's Address
Engineer's E-mail Address
City State
i. Zip i—® Telephoned-�
CONTRACTOR'S NAME/COMPANY
;� ,� �' yn �' vy 1 Lic No. , y / J Class l C
Contractor's Address ' - Lj ,Z,LL
�- Z ` } Contractor's E-mail Address _ a -
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City it /'t �� � m L �a * State
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E � -- Zip 1 I Z� � Telephone � � � T $
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. J� e
USE ZONE DEVELOPMENT NO PLAN CHECK FEE