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HomeMy WebLinkAboutX2017-3892 - Permit Application (3)'VeM-P Coo sheet for Combo Building & Solar Perm A licau City of Newport Beach - Building Division v r Comm 7/Residen4c� NOTE: P N CHECK FEES DUE AT TIME OF SUBMI g ilding (�/Vrading {� rainage Elec (! ech j Plum Cu Yd Cut / ��[�Cu Yd Fillrt (�0 Project Address (Not mailing address) F_ Flood , Liq Landslide F_N/A Floor �-Suite No of Work /Add SF 2� Remodel SF 1 (� Garag( e /Add (7 3 Use F_ ConstType� # Stories��#Units (if Res)1 Valuation .� f��U,, 4k, _ Material/Laa bor! . mot.! / OWNER'S NAME Last` First I �)© Owner's Address L- Owner's E-mail Address (000 l'CL1 �. Zoo City '�' 6 — State `/•ice Zip I Telephon T'1 L' 3'Z APPLICANT'S NAME Last First Applicant's Address l/ v V Applicant's E-mail Address City �j ! State ; r7!-�— Zip Telephone 1 v 1 � 4 G ARCHITECT/DESIGNER'S NAME %'�� � FirstL Lic. No. Last ( ,Cq ( 4WIW,(I � m1tiyv Architect/Designer's Address Architect/Designees E-mail Address City ti -- --- State C zip, -3 Telephone l ENGINEER'S NAME last I First L 4 i cc. No.� CZ Engineer's Address r / Engineer's E- ail Adnress City State p�� i �� Zip � f `2 Telephone; �F CONTRACTOR'S NAME/COMPANY Lic. No. Class I Contractor's Address City State Zip SETBACKS REAR SETBACKS FRONT SETBACKS LEFT USE ZONE SETBACKS RIGHT DEVELOPMENT NO Contractor's E-mail Address Telephone', PERMIT NO. PLAN CHECK NO. R PLAN CHECK FEES