HomeMy WebLinkAboutX2018-1006 - Permit ApplicationF Worksheet for Combo Building & Solar Permit Application
] yComm'l F Residential City of Newport Beach - Building Division
/\ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building FGrading
Drainage Elec i.- Mech F-PlumcuvdCut cuvdFill
Project Address (Not mailing address) I Flood r Fire F_ Liq r Landslide - /A Floor Suite No
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Description of Work
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#Stories #Units (if Res)F_
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Valuation
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OWNER'S NAME
Last C_Pg[ — Q First I �Vt Go12
Owner's Address
Owner's E-mail Address
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City/V _�a�r'¢"- .ea` -Vim_... State Cc,. Zip �/2i>6� TelephoneR 923^y330
APPLICANT'S NAME
Last C. I a, b First I,-
Applicant's Address
Applicant's E-mail Address
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City �ay- �
State I E Zip 52,707 Telephonel(7/„16.97"SV3J
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ARCHITE T/DESIGNER'S N
Last = First {{
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Architect/Designees Address
Architect/Designees E-mail Address
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- State �.ca.. Zip - e12 7 C7% Telephone Proo ` 1-0669
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ENGINEER'S NAME
Last First Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
- State Zip Telephoner
Lic. No. ���(��� ClasslCq.
CONTRACTOR'S NAME/COMPANY Si`jv �veca`a I,S kS _ CwJs+rr_-
Contractor's Address
Contractor's E-mail Address
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- State C� Zip Cj2%®% Telephone 0y)J ,//-60611
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT' PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $