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�co boilding & Solar Permit AP lication WP°Rr
City of Newport Beach - Building DivisionVT912
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUF�
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Project Address (Not mailing address) I Flood Fire [- Li L ndslide FN/A Floor Suite No
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Description of Work
Use VonstType (!/s
# Stories #Units (if Res)
Valuation $ I
Material/Labor /
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New/Add SF Remodel SF
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Garage/New/Add I
OWNER'S NAME Last ; /�'
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First
Owner's Address /J
Owner's E-mail Address
city f%jjt%i✓' % ix �� State I Zip C 1Telephoned
APPLICANT'S NAME Last/
First �/�
Applicant's Address
Applicant's E-mail Address
Fe / �Se� �_ �� I- �rll t_1 /A �,* I # �IZ6 9 1� �411X q�kw - �60; 4 �7
City `� v r� State `/
Zip ( _- Telephone MJ ,fGf --4e
ARCHITECT/DESIGNER'S NAME Last
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First F) (]lllz)
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City % r State
Zip f26 �2_ Telephone ¢ Sal% f ZP
ENGINEER'S NAME Last �j!,� f
First /cf Lic. No. e' 2 26 j
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone � 12 j%/
CONTRACTOR'S NAME/COMPANY
Lic, No.7�' „81 1 L& Class
Contractor's Address
Contractor's E-mail Address
F_
1-7
City State F_
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Zip Telephoned
SETBACKS REAR IQ' SETBACKS FRONT 1 V 9 PERMIT NO. 'ff � �
SETBACKS LEFT VIA SETBACKS RIGHT MIA.PLAN CHECK NO. �� l
USE ZONE PC-S7- DEVELOPMENT NO
PLAN CHECK FEES $ (ID J-1s