HomeMy WebLinkAboutX2016-0564 - Permit Application (2)cow`}- y
Worksho, W for Combs B, wilding & Solar PevrnR Application
Comm]-- Residential City of Newport Beach - Building Division J
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `
Building i Grading F-Drainage F_ Elec F_ Mech F' Plum Cu Yd Cut Cu Yd Fill
Project Address (Not ma-ollang
address) Flood F'" Fire j Liq (m Landslide FN/A Floor Suite No
Description of Work
Use Const Type I
# Stories _ — # Units (if Res) v'
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J
eq e SiJ
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Valuation $
Material/Labor
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New/Add SF C1a_ e- Remodel SF i Garage/New/Add
OWNER'S NAME Last
Chq,�l',Y-A First { 2c-u/lY1
Owner's Address
Owner's E-mail Address
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City I N' uivor-t oC ach
State Zip qy& &,3 Telephonel qL117— 2 3 3 - D 70
APPLICANT'S NAME Last i
i ven, First
Applicant's Address
Applicant's E-mail Address ari veer c� bw new oe&chi
City
State F Zip at7)`(p F3 Telephone
ARCHITECT/DESIGNER'S NAME
Last I Kan ry) First Lic. No. C (D°I�°�
Architect/Designer's Address
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Coo IL- Architect/Design'err E-mail Address
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City Vvi rw-
State I (1W Zip q rz i PI Q Telephone 914 , 724- j9 0 12-
ENGINEER'S NAME Last
fe-6, - jM I 'I/ I First /M Ctoa�'+J� Lic. No. C &(pi �
Engineer's Address
Engineer's E-mail Address
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City
State Zip Telephone 614cl' 2793At
CONTRACTOR'S NAME/COMPANY
2p �(Q t,;-., Lic. No. Fj Sz833 Class
Contractor's Addressnn
Contractor's E-mail Address
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t
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City � �
State Zip q (% 6 (o Telephone�y )17
SETBACKS REAR
SETBACKS FRONT l P 4]T NO.
SETBACKS LEFT
7
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $