HomeMy WebLinkAboutX2018-0408 - Permit ApplicationC
Worksheet for Combo Building & Solar Permit Application
F_ Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding r Grading
[—Drainage F_ Elec r Mech F- Plum CuvdcutF Cu Yd Fill F
Project Address (Nott mailing address) C Flood j— Fire F- Liiq F_ Landslide CN/A Floor Suite No
`/fS
Description of Work
Use Const Type
# Stories # Units (if Res)F—
{ N uk)
Valuation $ l�v"
Material/Labor `
New/Add SF
Remodel SF Garage/New/Add �— —
OWNER'S NAME
((r��,nn ^^ /il�' ,1
Last ��/n� First
Owner's Address
Owner's E-mail Address 54 1
2)� l
-iL , S&AT I IJC3Yy1�' NSC CC�v SSU N
City � i,-
State F �- Zip I "') l -Lj Telephone 9 T7 p��3 ` ,
APPLICANT'S NAME
Last First I
Applicant's Address
Applicant's E-mail Address
City -
State F— Zip � TelephoneF—
ARCHITE
Last -� First N �C� Lic. No.
Architect(Designer's Address
Architect/Designer's E-mail Address
2
- "IrPQfi NCtKat-3 M4'tJCk C_ov'/\
City Atli 0` State rA -- Zip Telephone -77�.!
/
ENGINEER'S NAME
Last First F Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City
State �� Zip �6 Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. F_Class[
Contractor's Address
Contractor's E-mail Address
City F_--- _
-_ State F_ Zip F Telephoned
SETBACKS FRONT PERMIT NO. ® C*v
SETBACKS REAR
V
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NOPLAN CHECK FEES $