HomeMy WebLinkAboutX2017-3988 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application o�aEWPo��
F Comm'!? -Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL CS<iFpM1NP
y'`,"Building h Grading (`Drainage V Elec ;Mech (Plum u vd Cut Cu vd Fill
Project Address
Not mailing address F_ Flood F- Fire Liq F- Landslide [_N/A Floor Suite No
100
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Description of Work
Use l � Const Type i V `
# Stories # Units (if Res)r
New/Add SFI
Valuation $max y�
Remodel SF Garage/New/Add �) Material/Labor tIJCJV "�
OWNER'S NAME
Last Cl First
Owner's Address
Owner's E-mail Address
v(01-
-
City ��
�(� State CIA Zip Telephone Q�fQ •Qi�
APPLICANT'S NAME
LastFirst
Applicant's Address
Applicant's E-mail Address
23y1-`� 3 C 0a/A -(V-.- (0 ( _Dfttt0 Ca, —"W• Cdu1
City ! Uk-,�( S State Zip �1,(p'� 3 Telephone F(tq - S;,? F - (05-0
ARCHITECT/DESIGNER'S NAME Last wrl � First (,o Lic. No.
Arch itect/Designeer,''s Address
Architect/Designer's E-mail Address
2�3(83 1A 6VONA
QfZ t:�(O�Ft DR,6XICAA Cd K4
City UA-(,c)k* t
W-S State FvF_ Zip (j po 53 Telephone 3 -'OST
ENGINEER'S NAME
Last 4 First Fro� Lic. No. C' -757?l(
l
Engineer's Address
Engineer's E-mail Address
City (rw(j V
State Zip �'Zj ( Telephone q( !�"1
CONTRACTOR'S NAME/COMPANY Lic. No Class '
Contractor's Address
Contractor's E-mail Address
City ;
State Zip ��- Telephone`
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $