HomeMy WebLinkAboutX2017-3033 - Permit Application (3)13
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^ Worksheet for Combo Building & Solar Permit Application �%C
F- Comm'I (`/Residential City of Newport Beach -Building Division >,
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding F_ Grading f -Drainage 1-1-Ifilec F/Nlech 7 Plum Cu vdcutCu rd Fill
Project Address (Not mailing address) F Flood f-_ Fire i" Liq F_ Landslide /A Floor Suite No
Description of Workf�F_V-�
Use ConstTYP e
AYJ CX(bl 1'ut LW (4j
t &3 3F A 1m cNI H .4
# Stories? # Units (if Res)?'
06 j (O A &(UILJ 1
r
�I?� iii �(�(41�CQ,�f1l��f 9W_?
fAN)� %A{
Valuation $ 0 60
Material/Labor Jk i
New/Add SF emodel SF. (r t,�,�j'j Garage/New/Add I
OWNER'S NAME 0 01 Last---
----- - First A -T c4m,C—___
Owner's Address
Owner's E-mail Address 450
'23((o PR 4rlA e 94Y0
City 13VA 1 .._ ajqcd
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State _ CFO Zip /l Z4 O Telephonel.9z/ 'd7/ - SJ'&
APPLICANT'S NAME Last
First u(I
Applicant's Address
Applicant's E-mail Address
1-:3163 01 690I XI
IR 1: 0(01 cit C DLOARc 4. aiq
City 1.666d&M [ 1,�S
_ State �ip ,. Zip „S,j Telephone.7i(q,51.?-165V
ARCHITECT/DESIGNER'S NAME
Last First ( P
�V 11 Lic No.
Architect/Designer's Address
/ Architect/Desgner's E-mail Address
Z X3I18
# to (�r� a 3th Gi+C. c�t�✓j
`3 �LA�.:����3DGM�QZ�
City lv (7�)�W, 1 (.cif' S_..
yU
State...: .—.. Zip 1G�.>)-7 Telephone 7."i-S73_'iOM ..
ENGINEER'S NAME Last
k First 21--Lic. No.
lei C wif`ill 94(7
Engineer's Address -
Engineers E-mail Address
City
State ty& Zip ' j Telephone 'yL 1---7,'�7.—?0j()
CONTRACTOR'S NAME/COMPANY
ni vST' t, e-1-0 Lic. No. %3S5/�ClassL
Contractor's Address
- Contractor's Address
3Iot 5 Ds3a2cc2
�/� �`bF ��)°q#00wCo,yj.
cityE
State �� Zip �j'23�'63' _ . Telephone X6_2S"--
SETBACKS REAR
SETBACKS FRONT PERMIT NO. f �j '' g160
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ Z 6D , 4S