HomeMy WebLinkAboutX2016-2907 - Permit Application (3)raW�Rr
Worksheet for Comb Building & Solar Permit Application of a
:Punt Fortp , � �
City of Newport Beach - Building Division opr
❑ comm" ❑ Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Grading Drainage ❑Elec ❑Mech ❑Plum curd Cutl Cu Yd Fill
❑Building ❑ 9 ❑
Project Address (Notmailingaddress) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor
L __or Suite No
i R � \ C a a c'-A-0,- h .' 1Q Ij7 7
Description of Work Use [71 Const Type E7
{
O_N 'cam I # Stories I # Units (if Res)C
e Valuation $
New/Add SF Remodel SF t 5 la Garage/New/Add N i Material/Labor
OWNER'S NAME Last SC J \\.-e C(ytM.00i, .First
Owners Address Owner's E-mail Address
City State —�, Zip - gj Telephone --
APPLICANT'S NAME Last
Applicant's Address
I
City State
First
Applicant's E-mail Address
Zip Cll Telephone'
ARCHITECT Last Last,�5-e. First �� Lic. No. �!
Architect/Designers Address Architect/Designers E-mail Address
�g t l
State
City( _'i. ZIP 1_— Telephone �{�",��.—''''I
/ j �r,a� Lic. No.:
ENGINEER'S NAME Last o 7 a� g d � ,�' First i
Address
City . State
Engineers E-mail Address
Zip L� Telephone�'
i
CONTRACTOR'S NAME/COMPANY
Contractors Address
I
City State
--J
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Lic No. �� t-lon_cp
Contractor's E-mail Address
Zip Z(p 'Z Telephone c..t, dr'— �(i `7-�, -- O 26
PERMIT NO. "li✓I (l �"
PLAN CHECK NO. �(4
PLAN CHECK FEES $
USE ZONE DEVELOPMENT NO