HomeMy WebLinkAboutX2016-0960 - Permit ApplicationLic. No. 2 i (�
Architect/Designer's E-mail Address
Acv-. & d1�_ I .co_-1
City L� Zip C ZCo 5 3 Tele hone
9 vn� i 5 State , e� j�`� p q ,1 g -S 7-3
ENGINEER'S NAME Last CC,
1 S -
Urn � rf- First C �, ,� y"1 Lic. No f -7g t I
Engineer's Address
City 0 r-c U State F<_ _x
CONTRACTOR'S NAME/COMPANY
x201W _0g0
Print Form Worksheet for Combo Building & Solar Permit Application
F Comm'I j`residential City of Newport Beach - Building Division
�� ,�-- NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTALr
1✓Building Grading F-Drainage F_ Elec
Mech F- Plum Cu Yd CutF_ Cu Yd Fill 1
Project Address (Not mailing address) r Flood f— Fire r Liq I— Landslide F_N/A Floor Suite No
Description of Work _
Us Const TypeW
r A
V'�'/ _ to # Units (if Res)
emodel SF ��`�--`- Valuation $
New/Add SF ' ( Ga g /New/Add 1 Material/Labor F
_
OWNER'S NAME Last
�-. e � Firstf,r�
Owner's Address
Owner's E-mail Address
City Cow PDC4-- g `owL� State — -
_ Zip �j&C) Telephone) qA C1 cl
APPLICANT'S NAME Last 1 -V&-�� 2\ • f
Applicant's Address
231 Ss. _ A11 (2.4 d e.11- 4D,--
/ s,) I -I✓ 10 1
City v_ 1� �'� s State
First!
Applicant's E-mail Address
Zip q Telephone 949 - 5 -7-5
ARCHITECT/DESIGNER'S NAME 4-
Last First F � i, G'
�
Architect/Designer's Address
2 3� g3 Imo. cf&,n-
Engineer's E-mail Address
12
Zip G ��(9 (� Telephone S I r 73'7-��C)
6C_ i s ,�Q ��,C Lic. No. Q�"Class
Contractor's Address / v
City State C —
_TBACKS
TBACKS LEFT
E ZONE
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
Zip Ji� Telephone
PERMIT NO.
PLAN CHECK NO. 05trl—
DEVELOPMENT NO
PLAN CHECK FEES $