HomeMy WebLinkAboutX2017-0712 - Permit ApplicationWorrZ
or Combo Building &Solar Permit Application o4�EW��a
[- Comm'[ (— Residential City of Newport Beach - Building Division 3
OTE: PLAN CHECK FEESI2UEACj TIME OF SUBMITTAL G <^"
[—Building [- Grading ainage rElec [-Meth �P(u Cu Yd cut Cu dFill F
Project Address (Not mailing address) F_Flood re F-Liq F_Landslid / Floor Suite No
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Description of Work I
Use F_ Const Type F_
# Stories #Units (if Res)
1�ebwlld 4of-k �e La C In-Flant.8R4k 911
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Valuation
New/Add SF� . Remodel SF _e-7 Garage/New/Add—
Material/Lab r
OWNER'S NAME Last �hLio (qid First E{ ci,
Ownee�r'rrs Address Owner's E-mail Address
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city C lV�l� State Zip ?� Telephone
APPLICANT'S NAME Last �J��` Y7 First
Applicant's Address Applicant's E-mail Address
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City lol,,yla D 97 State I " Zip CIZaoi�_ Telephoner
ARCHITECT/DESIGNER'S NAME Last I YA2.D A First I fF7iJ Lic. No. Fl pq
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Architect/Designer's Address Architect/Designer's E-mail Address
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City f) tS SLN• IP} a State (I / � / Zip /y L TelephoneF—
ENGINEER'S NAME Last First Lic. 07
Engineer's Addres Engineer's E-mail Address
City � State �. Zip F_ Telephoned®
CONTRACTOR' AME/ PANY.�f Lic. No.%ClassY7Y, Fe
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Contractor's Address Contractor's E-mail Address
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319®QI � N 115
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City J �y C State Zip 677 Telephone e 2
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N .
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $