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HomeMy WebLinkAboutX2018-0991 - Permit ApplicationWK) �tov, '� X70(9_0qqi Worksheet for Combo Building & Solar Permit Application 7 Comm'I Residential City of Newport Beach - Building DivisionX, NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 1�Building o Grading [--Drainage j �ElecMech I Plum Cu Yd cuts Cu Yd Fill Project Address (Not mailing address) F_ Flood F_ Fire Liq Landslide I N/A Floor Suite No r Description of Work (JC�C/ Use ConstType! i # Stories; #Units (if Res) i i �►�: FLa-Z_ UV 1(1 2A 11 3 SA,�-s� III' ` �,al� fi New/Add S Remodel SFr (? Garage/New/Add �� Valuation $ Material/Labor r 15(c) OWNER'S NAME P Last First J Owner's Address 4 160 Owner's E-mail Address i I, azUt5 € 1?c,Ur F I City(�,� I�u l�ls! State Zip 0 Telephone - "7� '" ���fo APPLICANT'S NAME Last 16jgj Le-Y First i �� D Applicant's Address Applicant's E-mail Address f t�3 Lip OEW � (o i[7ys_jt0 C ����+, Co City ) $ State I l' f Zip i (� Telephone 6 4 (- S7 0 0 ARCHITECT/DESIGNER'S NAME Last ; �f9"( (.A(// ( First Wit) Lic. No. C 27 y0 N Architect/Designer's Address Architect/Designer's E-mail Address City , � JAIA U,5 State Zip Telephonel l(� ENGINEER'S NAME Last First Lic. No. C 8-793 Engineer's Address Engineers E-mail Address 2S15�t� �I2 1OZ City Di�j_tja kt s State F Zip i Telephone! CONTRACTOR'S NAME/COMPANY2e`2c�^5,��fibn Lic. No. Class �� Contractor's Address Contractor's E-mail Address 4 City (IV�`5SV\�© State Zip CiZ � Telephone'C1LkCt_ 6'7S.Z��C1 ETBACKS REAR SETBACKS FRONT PERMIT NO. X"1.�q o ogcf SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. m(p _ USE ZONE DEVELOPMENT NO PLAIN uttEurl- FEES $ I