HomeMy WebLinkAboutX2018-3499 - Permit Applicationcc
c�.rl
I�Z zoo
ks eet for Combo Building & Solar Permit Application
(- Comm'I tesidential M� City of Newport Beach - Building Division U{}(
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
PEui4ding F_ Grading F-Drainage �Elec Mech
CuvdCut F Cu Fin F_
a /A
Project Address (Not mailing
address) C Flood
ire Liq r Landslide Floor Suite No
F F_
1 � zl.c N
ps —
Description of Work
at
to C ee_m
Use R—PL1Const Type V-(zj
L
KOW �d
# Stories # Units (if Res)[
nppL
�N(fl NL� s&•
��&ln-e��
Valuation 5
New/AddSFF_ Remodel SF 'I� Garage/New/Addy—
Ma3olt/Lbor 50(Pc
OWNER'S NAME Last
ti/"/��,p�
First J04N >nnel
Owner's Address
Owner's E-mail Address
City Ivf�vv���i,l,�- rJ ,ef.�-
State
Zip Telephone �g7 �, (9
APPLICANTS NAME Last
{T /� r �
'1v `^
First h/4,0"
Applicant's Address
I`
Applicant's E-mail Address
`(moo (@ C 116s
i)P5(,�
City FIV P2
State F ewZip � �-2�� Telephone 94Q cE-,9005-
ARCHITECT/DESIGNER'S NAME
Last
First F Lic. No. -
Architect/Designer's Address
Architect/Designer's E-mail Address
city
State
Zip Telephone
ENGINEER'S NAME Last
First F --- Lic. No.�—
Engineer's Address
Engineer's E-mail Address
City F—
State F_
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. r--_ Class1r__—
Contractor's Address
Contractor's E-mail Address
City F--_-
State F—
Zip F— Telephoned-e
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. XZ0 (J` -8q 70
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. /''' - ZQ( l
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $ L c)<T) .