HomeMy WebLinkAboutX2017-0455 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application o°6�Po
Comm'] �' Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
uilding F_ Grading F -Drainage F-Elec F_Mech F- Plum Cu Yd Cut F— Cu Yd Fill
Project Address (Not mailing address) F Flood r Fire (-" Liq r Landslide FN/A Floor Suite No
2 3�
k.ew � I L F
10 COLT- cry c
Description of Work
Use F—ConstType F
# StoriesF_ # Units (if Res)F—
c A�a049Z
Valuation $
Material/Labor
New/Add SFF_ Remodel SF F—
Garage/New/Add
OWNER'S NAME Last
TA(dj J
First
Owner's Address
Owner's E-mail Address
VS- 2—( , �S
At,
4 jo��
City rV to
State �'
Zip. 9 0/L. Telephone_ 9IC1,9 %,F3
APPLICANT'S NAME Last
%C c o2/!/1 4
Firsts
Applicant's Address
Applicant's E-mail Address
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I CX -G. % (
!+¢4,C 4.I ir�C'e.z f't•-'�e c/T/ c.v .CQ�,
City CL- 4�r .r2 v -W /.`
State �`�
Zip < ✓�I� . Telephone `7G F. ro,?v r2 pC/
ARCHITECT/DESIGNER'S NAME
Last First F Lic. No. IF—
Architect/Designer's Address
Architect/Designer's E-mail Address
City f a
State F
Zip F Telephoned---
ENGINEER'S NAME Last
First Fss Lic. No.w
Engineer's Address
Engineer's E-mail Address
City _
State F
Zip r--� Telephonel P�
CONTRACTOR'SNAME/COMPANY
CSL ��
Cc.� Lic. No. 6 s
Contractor's Address
Contractor's E-mail Address c
City I L. � R �n v ai T
State C l�
Zip 9/ 7I� Telephone1 �,a F ( :�L1
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $