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HomeMy WebLinkAboutX2016-0027 - Permit ApplicationX 201 U - 00Z-� Print Form Worksheet for Combo Building & Solar Permit Application Use R jComm'I r Residential City of Newport Beach - Building Divisiong�- NOT�N CHECK FEES DUE AT TIME OF SUBMITTAL NZIN-" -`,Building rGrading rDraina 0jjElec riMech rPlum Cuvdcutl CuYdFill � Project Address (Not mailing ress) f Flood r Fire r Liq r' Landslide rN/A Floor Suite No Net��ost- C�_ D,(- F F—' Description of Work e FM_I Const Type (' — (Y1�nn�T.(. cn 6cstJ, C' MCkn d�� t�sS rPon l� v # Stori k Units (if Res)F WCA�� � I T4JC Y`I'•!C� (. UI� ✓,fir.. ���,/ (�B �✓,�t^ dni JCE�= Valuation So© Material/Labor R r New/Add SFF �- Remodel F r7�1 2, Garage/New/Add ��^ ' OWNER'S NAME Last �s First _ Owner's Address Owner's E-mail Address .... Zip .... Telephone City (' �._ _... ._ State I F; I _ APPLICANT'S NAME Last Co_r_' Cc First Conr�� Applicant's Address Applicant's E-mail Address Po _ P20y- _t 4(o CIO V1>n�(;Jl CO3x-t,:x- City o _. State Zip qx 7tv ` Telephone7(t(&2qc)q ARCHITECT/DESIGNER'S NAME Last A,,&kR*:-P_fS First Lic. No. C-N 4 a `] � M� I� Architect/Designer's Address Architect/Designer's E-mail Address T,Lo- A-V- City CS(nEsrvts_n C)c t(_9 State CA- Zip 4 (4-1 Telephone @E-5-1-F 306, ENGINEER'S NAME Last c--^ First F_ Lic. No.F_. Engineer's Address Engineer's E-mail Address City State r Zip �— Telephoned—; NTRACTOR'SNAME/COMPANY r�,¢j.f D �ic.No. 79t7QZ'7 Class; �� �Lnw�t nT( _ Contractor's Address Contractor's E-mail Address 3C9�i 3)atrn.e S __ L>Xara,�a g,l-t,�4Gon, r_"&�jc-,-,'4c.i City Gp co net ; State Zip ��g7�/; Telephone is�i z7?- %J:7(o Z SETBACKS REAR SETBACKS FRONT PERMIT NO, SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N `oL��3�•���I USE ZONE DEVELOPMENT NO PLAN CHECK FEES $