HomeMy WebLinkAboutX2018-3511 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F— Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F-Drainage lec Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F- Fire f- Liq F- Landslide Floor Suite No
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Description of Work _
Use ConstType 6�
# Stories y #Units (if Res)
Valuation 5 �-^
Material/Labori.4. I lam,
r
New/Add SF r% 0 f Remodel SFIF r' Garage/New/Add --
First
OWNER'S NAME Last ) ,6 ,�/fy/
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Owner's Address �tit..'C�GV1 �L�A.I✓� Owner's E-mail Address
City �'C.rw. &q,/State Zip F Telephone' 3tp —¢ �jj
APPLICANT'S NAME Last/I /6,-V1 Q First'
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Applicant's Address Applicant's E-mail Address
City State Zip Tel
ARCHITECT/DESIGNER'S NAME Last i First Lic. No. t
Architect/Designer's Address ArchitecttDesigner's E-mail Address
I t
city State Zip �— Telephone'
ENGINEER'S NAME Last First 7if�',��� Lic. No.111
Engineer's Address Engineer's E-mail Address
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State I— Zip1�2.&Z� Telephone
City 4 51 yt,��
CONTRACTOR'S NAME/COMPANY Lic No,
Contractor's Address i�b., Contractor's E-mail Address
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i
city State F— Zip 11 Telephone'
r 9 2
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE i DEVELOPMENT NO PLAN CHECK FEES �• -'Z—° ��
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