HomeMy WebLinkAboutX2018-1578 - Permit Application (3):e 0M Worksheet for Combo Building$ Solar Permit Application
C Comm'l CI Residential City of Newport Beach - Building Division X O' t•
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building [7 Grading CDrainage ❑Flet j Mech [_ Plum Cu Yd cute Cu Yd Fill Fl
Project Address (Not mailing address) C Flood ❑Fire ❑ Liq �; Landslide CIN/A Floor Suite No
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Description of Work
Use l l Const Type
Sla C tf2 GIY' Wj+V1 VatrnaJ tea,+ Y7
#Stories #Units (ifRes)�
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New/Add SF�� Remodel SF� _] Garage/New/Add
Valuation $
Material/Labor
OWNER'S NAME Last First
Owners Address Owner's E-mail Address
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City _— State �� Zip F— 7 Telephoned
APPLICANT'S NAME Last �— J First
Applicant's Address Applicant's E-mail Address
City State Zip F---- I TelephoneF - ___7
ARCHITECT/DESIGNER'S NAME ��
Last — -- --- - ----I First I Lic. No.
Architect/Designers Address Architect/Designer's E-mail Address
City ( State Zip Telephonel
ENGINEER'S NAME Last - - - l First r Lic. No.F_1
Engineer's Address Engineers E-mail Address
city � State �I Zip F_77 Telephoned
CONTRACTOR'S NAME/COMPANY W'khykQ CuS Lic. No. (�92 Class�l
Contractors Address Contractor's E-mail Address
385 5j,z44(po S'a C,Qwiv1 �I_e(� vnRl l •
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City State <'< Zip �249(OQ I Telephone 1149 F %5.3,(a S
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $