HomeMy WebLinkAboutX2016-2907 - Permit Application, 20n-2jrIv
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Worksheet for Combo Building & Solar Permit Application 011�0�1
Residential City of Newport Beach - Building Division 'j p Hit
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Description of Work
Use Const Type I
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# Stories— #Units (if Res) —
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Valuation $ F
Material/Labors 5
New/Add SFRemodel SF; Garage/New/Add , 11-31 Ar
OWNER'S NAME Last �,�.�^��,N��q�^^y' �rsti
Owner's Address Owner's E-mail Address
City NCvO �,c �- e0.cy`,-c State C }4 Zip I Telephoned
APPLICANT'S NAME Last First I
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Applicant's Address Applicant's E-mail Address
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City State Zip Telephone��
ARCHITECT/DESIGNER'S NAME Last I �eX'T G�A� �,QF�%st Lic. No. �v
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Architect/Designees Address Arch itecNDesignel's E-mail Address
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City j� State Zip Telephone
ENGINEER'S NAME ti e_,x irst'� Lic Noe, Last' 1„ 1 z�
Engineer's Address Engineer's E-mail Address
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City' �QtF-2 State I zip 1.9-a'P3 C) Telephones
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CONTRACTOR'S NAME/COMPANY j ; Lic No. lq ,�ti wy2 Class .2j
Contractor's Address Contractor's E-mail Address
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City \ State 1 Zip g3OJI Telephone,91u -j— _T, d�U� C0.�1S'�iGt1 1 Lv I �l ��,�
XS REAR SETBACKS FRONT PERMIT NO. k2pI
MKS LEFT SETBACKS RIGHT PLAN CHECK NO. IQ72/'VJ• ?�(! �'�
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