HomeMy WebLinkAboutX2018-1475 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
Comm'Iresidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) 1- Flood F_ Fire r-,Liq F- Landslide CN/A Floor Suite No
j6M W
Description of Work
Use F_ Const Type F—
#Stories # Units (if Res)
Mate al/Lab r 1'7 4
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New/Add SFj Remodel
Garage/New/A
OWNER'S NAME Last I Gj'rAmz,�
First
Owner's Address
Owner's E-mail Address +
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City N( --v - State I }
Zip 1 74WO— TelephoneF—
APPLICANT'S NAME Last
First I � U,
Applicants Address
327�o PW -C7 k AVO
Applicants E-mail Address
City I 000M meso, State I "
Zip F"^°"'•' Telephone 7/4.422 COeE,
ARCHITECT/DESIGNER'S NAME Last F /t/�� First (J(h(� Lic. No.Z�
Architect/Designer's Address
Architect/Designer's E-mail Address
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jMUk0WlUW/,W srol�l 1��
City I C061-. MOSIA, State icy 1
Zip F qzwe, Telephone 77
ENGINEER'S NAME Last i��+-► I
First 5) Lic. No.
Engineer's Address
I/ 2 Gf-�(�I.NtiN
Engineer's E-mail Address
MG c4Fs;Ag5oj • M4)4(?- C0.11A1 L .Co M
City _ Uw�j State
Zip �Z Telephone 7i- qR7- %/W
CONTRACTOR'S NAME/COMPANY
Lic. No. F Class F_
Contractor's Address
Contractor's E-mail Address
City State I
Zip I Telephone,
SETBACKS REAR SETBACKS FRONT
S_ PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
j PLAN CHECK NO.