HomeMy WebLinkAboutX2018-1775 - Permit Application01 111;5
Print Form -_1 Worksheet for Combo Building & Solar Permit App icatlon
Comm'I [Residential City of Newport Beach - Building Division 60, / NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building El Grading ❑Drainage,�AElec [7Mech , lum Cu YdcutF-7��
Cu Yd Fill
Project Address (Not mallh
501 t,/
Description of Work
Flood [] Fire ❑ Liq [7 Landslide 04/A
Floor Suite No
L~ V Use
JRed Const Type I I/
L_J
# Stories #Units (if Res)1-7
New/Add SF % Remodel SF ��]. Valuation $
'—X Z Garage/New/Add �� Material/Labor //�
OWNER'S NAME Last
Owner's Address
City _��� State
First
Owner's
�E-mail
'Address
Zip I �'e:� U3fJ Telephone
APPLICANT'S NAME Last
Applicant's Address
City �iJ� �7 _ State L' J
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
1/6 1 C _
City M/�'� e� State
Applicant's E-mail Address
Zip �� Telephone CljrelQ -y
First
Lic. No. F73g37/79
Architect/Designer's E-mail Address
ZIP r/�Q Telephoned
ENGINEER'S NAME Last� ----] �C^
First
Engineer's Address
CityState
Zip
CONTRACTOR'S NAME/COMPANY
Engineer's E-mail Address
Lic. tdo.
F
Lic. No. 1777 Class 1-7
Contractor's Address
City State
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Contractor's E-mail Address
Zip TelephoneL771
PERMIT NO.
PLAN CHECK NO. 'Z,7 s
PLAN CHECK FEES $