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HomeMy WebLinkAboutX2018-0746 - Permit ApplicationX20I g D I I I=rint 1 orm Worksheet for Combo Building & Solar Permit Application r Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �.o.+•' rBuilding 'F<GGrading rainage ec Tech Plum CuYdCut F_ CurdFill F_ Project Address (Not mailing address) r Flood r F`ire Liq r-Landslide r N/A Floor Suite No 4 I Z Ltk6o h io. � r `S - 7 f_ F 2 F__ of Work Use Const Type I vA # Stories It Units (if Res)- ADescription 1- N 2 !t �r t 3. Valuation $ I4 (�O® Material/Labor `7V , New/Add SF Remodel SF q Garage/New/Add �— OWNER'S NAME Last Ia CoFirst I 6VN_e_j Owner's Address Owner's E-mail Address L112 lluka o n to o. S re_e._ City YU QW_ Po ZTQT State CA Zip F_ Telephonel 6 APPLICANT'S NAME Last Richart', First Jason Applicant's Address Applicant's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. F_ Architect/Designers Address Architect/Designees E-mail Address 1041 W. 18th St, (A106) Jason@dchartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ENGINEER'S NAME WANKET AL Last ', First NELic. No.1 Engineers Address Engineer's E-mail Address `l3020 a P, 1 N N9werir^�•Covr City I Te.r \e cLJxl. i State FA Zip 2, 1� Telephone ( BSI—So6_6 / 4S CONTRACTOR'S NAME/COMPANY C ` Lic. No. Class Contractors Address Contractor's E-mail Address — /.�_s G+�ov,\�.c` State E—t Zip IZ7o`/ Telephone ?Tc?—Z �- city r_)N`—t SETBACKS REAR SETBACKS FRONT PERMIT NO. XMI , 1 l4o SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 06110 . Q,p is USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ er t G) n (—