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HomeMy WebLinkAboutX2016-2909 - Permit ApplicationBoa_ xgqu Print Form Worksheet for Combo Building & Solar Permit Application oFe Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r" ❑Building F_Grading F—Drainage F7EIec C_Mech ❑Plum CuYdCut E71 CuYdFill 171 Project Address (Not mailing address) ❑ Flood F] Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No Description of Work Use F7 ConstType # Stories© #Units (if Res) ati �.2 r2 e :c Valuation New/Add SF tJ A, Remodel SF 1 q ! Garage/New/Add $ Material/Labor OWNER'S NAME Last �C--J �L.e Cam,-, ,n�M First `r�°�Owwn�er's Owner's Address E-mail Address City we.��Oc Q -o State Zip Telephoned APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State F-1 Zip TelephoneE-7-7-7 ARCHITECT/DESIGNER'S NAME Last S�-e� g��WtLic. No. ArchitecUDesigners Address Architect/Designers E-mail Address City �.-0.�C State C/ Zip Telephone ENGINEER'S NAME Last First Lic. No.F_ ngineer's Address Engineers E-mail Address City —I State IJ Zip Telephoned CONTRACTOR'S NAME/COMPANY 1/ c!7 Lic No.nL��� Contractor's Address Contractors E-mail Address Yec_ov, C City State' - Zip Z(p Z Telephone 9 q— i gI g -_, O 2E. SETBACKS REAR SETBACKS FRONT PERMIT NO. —a! 8 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ��y • -77�/ (Q USE ZONE DEVELOPMENT NO PLAN CHECK FEES $