HomeMy WebLinkAboutX2016-3864 - Permit ApplicationWo"rksheet fo;�"I'o Building & Solar PermitARC: 't' "*
City of Newport Beach - Building Division��
1"-1 Cnmm'I .IRS Residential ..� nuonv ❑occ D is AT TIRAr nF SI IRMI
jBuilding 4 Grading DrainageVjElecjMechPlum cuvdcuc l�o cuvdFlll (gyp
Project Address (Not mailing; address) ❑ Flood Fire Liq ❑ Landslide N/A Floor Suite No
Description of Work Use ConstType v�
3
# Storiesr—� #Units (if ResfT I
Valuation 5 1
i Remodel SF� Garag�Add �� Material/Labor
e' /Add SF t
��
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
i
City State —1 Zip Telephone 9a��.17
�t�
APPLICANTS NAME Last) First._
Applicants Address A Applicant's E-mail Address
State Zip. ��,( � Telephone V 27`�-,(2i'3,'2-t
city jc ... -
ARCHITE E NAME Last+Q�. - - I firstF Lic. No
ArchitecUDesigner's Address Architect/Designer's E-mail Address .
... F-- -- -)
City [ /tt `� State Zip 1� Telephone �— yT b�j i r}
ENGINEER'S NAME Last Lic. No , S2s9
�t r� First - _..
Engineer's Address Engineer's E-mail Address'
City State Zip �2lpC� TelephoneZl�,�
CONTRACTOR'S NAME/COMPANY Lic. No. Fgpg/�- Class �-/,?
4ocd11�tC.�o�QrS L� --. .
Contractor's Address Contractor's E-mail Address q 64t(e v P e r I -c
City /12SG State I Zip �'2E2� Telephone c'cfS)-�q7^�`J93'
- - --- -- ---- ----
--
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
J
Y\�v w•c — r