HomeMy WebLinkAboutX2013-3325 - Permit ApplicationX���-332J
PnrWorksheet for Combo Building & Solar Permit Application °
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
1�ellding F-Grading F-Drainage F�'eec 1-1Mech [,—�!Slum CuvdCut F_ CuvdFill F_
Project Address (Not mailing address) F_ Flood F- Fire r Liq r Landslide FN/A Floor Suite No
Description of Work
Use Const Type
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k Stories[ 4Units (if Res)
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Valuation
Material/Labor /
New/Add SF� Remodel SF��
GaragelNew/Add �-
OWNER'S NAME Last r2tD�PLF_ First�.ISr'�,�
Owner's Address
Owner's E-mail Address
City (3A _ A State �-
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APPLICANT'S NAME Last
First.a✓wt S
Applicant's Address
Applicants E-mail Address
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City '/3A 1,13J A T_ S,A-✓'� State - �
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Zip c12 G b'L.. - Telephone _. y 5 _ G 7') --
ARCHITECT/DESIGNER'S NAME Last
i First LicNo. �—
ArchitectlDesigner's Address
Arch ftecifDesigner's E-mail Address
City � _ _ _ State r--,.!
Zip [— Telephonel—
ENGINEER'S NAME Last
- First —I Lic.No.F
Engineer's Address
Engineer's E-mail Address
City State--
Zip Telephonei. -
CONTRACTOR'S NAME/COMPANY �� (A 2F t-i_,
�,,r SMN�N„ Lic.No. yew yc Classe—
Contractor's Address
Contractor's E-mail Address
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City IJ%�✓ )n ..1 , ,n State
Zip .S �L (� Z .I TelephoneK
SETBACKS REAR SETBACKS FRONT
'?7
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT ..
PLAN CHECK N . >, 40C 13
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ -