HomeMy WebLinkAboutx2018-1543 - Permit ApplicationPrint FormV19 S gee for Combo Building & Solar Permit Application naz
[ -', Comm'I ar_so�sidential D} — City of Newport Beach - Building Division
OTE: PLAN CHECK FFFS r7I IF AT TINAF nF CI IRRAITTnI
Fy-, uilding r Grading_ rainage C Elec [7 Mech n Plu Cu Yd Cut Cu Yd Fill 7 171
Project Address (Not mailing address) ❑Flood ❑ re Liq C Landslide ❑N/A Floor — Suite No
Description of Work Use P;7 Const Type
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# Stories #Units (if Res)
—; '� Valuation $
New/Add SFIr� Remodel SF Garag a/New/Add Material/Labor
OWNER'S NAME Last FirsI Ilk!
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Owner's Address Owners E-mail Address
City �— _ —i State Zip.( Telephone J
APPLICANT'S NAME Last _ �_ First
Applicant's Address Applicant's E-mail Address
City State Zips Telephone. J
ARCHITECT/DESIGNER'S NAME Last a4_ First { lot—_ Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
,city State F-77 ..Zip Telephoner
ENGINEER'S NAME Last -_ First Lic.No.
Engineer's Address Engineer's E-mail Address
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city r _ State F77Zip Telephoned I .;
CONTRACTOR'S NAM /COMPANY ? �k � 11 Lic�No. �/�()6cj Class' C�
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Contractor's Addres Contractor's E-mailA"ddress
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City �jZD(JS� Statel � �J Zp �rg8jg" J Telephone
.SETBACKS REAR SETBACKS FRONT PERMIT NO../�/ �(,^`� �r
SETBACKS LEFT - SETBACKS RIGHT PLAN CHECK N P I hb •�,QT�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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