HomeMy WebLinkAboutX2016-2008 - Permit Applicationf
PnntForr Worksheet for Combo Building & Solar rmit plic UoN
C Comm'I C Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[i'Building [7Grading EDrainage ❑Elec Fl Mech ❑Plumcu Yd cut F771 QYd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire F7,Liq F-, Landslide I JN/A Floor Suite No
CED (
i�y� csd t11"l/A�i�, — — — �C �I
Description of Work Use Const Type
R6.i5 Je_D Dr- .6XI S7 ��C flc' l8T1 #Storie' 4Units(ifRes)F7
— - -- --- 7
New/Add SF Remodel Remodel SFGarage/New/Add'.
OWNER'S NAME Last I s r rz,-/4/Jl First
Owner's Address Owners E-mail Address
City W4 �P�±E'-#- L,. state Zip
APPLICANT'S NAME Last
Applicant's Address
--
city�1T
First I A4.A/
Applicant's E-mail Address
Zip 1z_—.�' TelephoneF7
ZD0�?P
e
ARCHITECT/DESIGNER'S NAME Last �-
� First Lic. No. ,A
- c�37�
Architect/Designers Address
FOX
City State L
Archiitect/Designer's E-mail Address
�7 v�
Zip...__Telephone / -- (�("�!j-Z•�-
ENGINEER'S NAME Last �e � First/`'�4__rC____,, Lic. NoTTV_5A?
Engineers Address
City 5 State^,
NAME/COMPANY
Engineer's E-mail Address
Zip 71 Telephone g�' 3 P �jo
Contractor's Address
City �'y.— — - State Zip
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Lic. No. 's Class - g_ _
Contractors E-mail
ell a 'A 7-/i I -Wif'O'n
PERMIT NO
PLAN CHECK NO.
PLAN CHECK FEES $