HomeMy WebLinkAboutX2015-3098 - Permit Application (6)Print Form 'i'rVorksheet for Combo Building & Solar Permit Application o��`�Po
r, Comm'I r Rel!(enfi`af City of Newport Beach -Building Division 3 L(� vj�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL C) 1(kJ✓'� v<,.o.r,.
r:Building r- Grading rDrainage r;Elec r: Mach r- Plum CuvdCut F CuvdFill
Project Address (Not maili g address) r, Flood r Fire r Liq r! Landslide rN/A Floor Suite No
Description of Work
Use F—Const Type F_
i) till �(� /Gtc l INGuLd/L I�LRT T/ l/G h`T
# Stories, # Units (if Res)'-
_.
Valuations -_
Material/Labor Fy,f (%
New/Add SFF_—, Remodel SFF
Garage/New/Add F—',
OWNER'S NAME Last L/0/0 /Ge.T9�/
L[C` First ...
Owner's Address
Owner's E-mail Address
3;bL_,�I�WPD/l/� /�C fu/rC/ou
City /� ,Ov4 ✓ ,0ay _.. State F57
Zip .7166.? Telephoner........ .
APPLICANT'S NAME Last �'t�tl/k/hI�SL /.Uc
First
Applicant's Address
Applicant's E-mail Address
J
AtVItMN/tX. oo i- ,, r e
City State F(_�—
Zip rLJ52 Telephone y--(•..1j—.�//DI', _....
ARCHITECT/DESIGNER'S NAME iI&O � F_ F
Last t f (f0/Q /°� .First Lic. No.F_
Architect/Designer's E-mail Address
City I'j 61?,. ' State (f
Zip [ /%�. J"_. Telephone 3/ Q .. ??<5oi. Z. _...
ENGINEER'S NAME Last 67&//c.Le-.L
First f%�� Lic.No.F_
Engineer's Address
Engineer's E-mail Address
/?JOU kcoN/CC 2 ala
.._
City La�4tx) State C".g..._
Zip '?ZG /�(. Telephone �j' Yf'—LJZf3jJ7�
CONTRACTOR'S NAME/COMPANY ("iy�1
Lic No. 7 c/xJ-fu, Class(
Contractor's Address
Contractor's E-mail Address
City c7 r i1 y_ State I /lrrL�4
[—R,),
/J
Zip QZ i / v Telephone 6 Z IiCX>O
SETBACKS REAR SETBACKS FRONT
PERMIT NO. P
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
y (�,,VIW-I'a t