Loading...
HomeMy WebLinkAboutX2016-3763 - Permit ApplicationWorksheet for Comb, y Comm'I Building f Residential 9 &Solar P City of NewpOK Beach - Buildin Permit A at10 uildin NOTE: PLAN pplic g Grading CHECK FEES DUE AT TIME OF ision n Pro g Drainage j-Elec Build. SUBMITTAL O0. Jett Address (—Plum (Not mailing address ardc f CU r ,Q ) r Flood r Fire N,,A 11 r Liq r landslide rN/q Floor description of Work `0 suite l s I Use 1► t TYPe New/AddsF- �� < #storie .� # - � Remodel SF�—�-- nits (if Re s)F_ OWNER'S NAME Garage/New/Ad r�� Valuation $ Last Material/Lahorl Owner's Address �e� v 1 First r It C Ty s `� Owners E-mail Add res � k)z State APPLICANT'S NAME Zip I -- Last z Telephone *� Applicant's Address ` 6 I iQ _TsC (' 7d, First City Applicant's E-mailq �s�� Ilk�p-ypc A b State ,� d3 ARCHITECT/DESIGNER'S Zip - NAME T8 phone Architect/Desi Last (��' SIC ✓� First SL -C Q l�. Architect/Designer's City _ +P 0± � d w°E- ��--- -_ O mail Address Lic• No. AC'r 1 State p Last ENGINEERSNAM Z�)���- E 4� Telephonel�� 11 LL7_ En'lgineer's Address !'(�A (_"yam % / First��- h t� ®� Lic.No City Dt�, d�'-1 Engineers E-mail Address l %O ! CONTRACTOR'S Zip NA Telephone 7 ess ContractorState s AddrG� 167���� HO�c� �E � _ Lic. No. U ��� L�,� „A y� Contractors " " 7x/- Class ity ' `�ij ,V "�J' .� E-mail Address �►t A State Zi� L�1 . 'BACKS REAR P �a , ZZ TelepI �— � iy� ~C 4+1 -- �01 BACKS LEFT SETBACKS FRONT ` 59� `;W ` Co J,� ZONE SETBACKS RIGHT PERMIT NO. DEVELOPMENT NO —� PLAN CHECK NO.