HomeMy WebLinkAboutX2014-0816 - Permit ApplicationX2ll Osly
f, j o 7� Worksheet for Combo Building & Solar Permit AP, lication
❑I Comm'I F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
J—IfBuilding r7Grading F Drainag �t,Elec ['Meth r;Plum cuvdCut cuydFiu
Project Address (Not mailing a ress) C Flood C ; Fire [; Liq �L ndslide Floor Suite No
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Description of Work
Ca "L'"�
New/Add SF 0j�yp Remodel SFr � Garage/New/Add F77
OWNER'S NAME Last
First
Use 3�t1—jl Const Type
# Stories�I # Units (if Res)EI
Valuation $
Material/Labort°Dt1�� -- -
Owner's Address Owner's E-mail Address
City �� State ;Z ZipFq Telephone'7f¢w
APPLICANT'S NAME Last
Applicant's Address
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City lc�—et'-.%'�_..._._.._.._._._— State
First
Applicant's E-mail Address
J
Zip -.--...� __I Telephone 3i...'?"LZ..i t
Last i First j Lic. No.
Architect/Designer's Address
City C—� State
Architect/Designer's E-mail Address
i
Kz
Zip Telephonel——�
ENGINEER'S NAME Last First Lic. No.
�c t
Engineer's Address
City ' i_�--- _ State
Engineer's E-mail Address
Zip .J! 545--_JJ Telephone ` iv ,
CONTRACTOR'S NAME/COMPANY
iL� c No Q3(d� j Class
yl
Contractor's Address
City State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip ... KO`.7 __' Telephone 7/C/IGp
PERMIT NO. - &W �rA
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $