HomeMy WebLinkAboutX2016-2142 - Permit Application.,rf�tg€oaFm Worksheet for Combo Building & Solar Permit Application GQComm'I ❑Residential City of Newport Beach - Building DivisionNOTES PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading
Drainage let ❑Meth PI CuvdCutF_ cuydriuC
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide CN/A Floor Suite No
P06
Description of Work
Use C' ConstType 177
-
E� L✓ ��j # StoriesF # Units (if Res)!
New/Add SFajj 6RAr
Valuation $
Remodel SF�— Garage/New/Add Material/Labor
OWNER'S NAME
Last First5RQ
Owner's Address
� Owners E-mail Address
City
State Zip Telephoned
APPLICANT'S NAME
Last �(- First
Applicant's Address
Applicant's E-mail Address
_
City
-
State —'�, Zip F Telephone��,
ARCHITECT/DESIGNER'S NAME Last �' �� First J! Lic. No. _-
Architect/Designers Address
Architect/Designees E-mail Address
Last-vt"►J I �s
N �•U1.J ' '., ._ _----
City State Zip 9Telephoned
ENGINEER'S NAME
Last ,F��i�rst .., Lic. No.F77_7
Engineer's Address
Engineers E-mail Address
City
State Zip ', Telephone __
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractors Address
Contractor's E-mail Address
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City F
-
f State , Zip Telephone
SETBACKS REAR
SETBACKS FRONT eLo PERMIT NO.
SETBACKS LEFT to
SETBACKS RIGHT [Q r PLAN CHECK NO.
USE ZONE —� G di7t? DEVELOPMENT NO PLAN CHECK FEES $