HomeMy WebLinkAboutX2018-0966 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
f Comm'Ieesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading F-Drainage FAIec )&ech
KPIUM CuvdCut CuydFill
�
Project Address (Not mailing address) F_ Flood
i- Fire F_ Liq Landslide F_N/A Floor Suite No
F_ F_
Q-(o I IMvt2 SE -A 6a9:G1FbC t tOA&
`
Description of Work
Use $FD ConstTypV
# Stories
Apolu 5f cr LOttla S�'AF$
INclut�lr�
Daut� t2 tNAsrfc.gr-.0R«OM aHO rLIEYatoK.
Valuation $ ^
New/Add SF' 2�' Remodel SF �p s�
arage/New/Add r
Material/Labor 5 f
OWNER'S NAME Last '3'� L �� First
Owner's Address
Owners E-mail Address
P.O. PJo)C 'Z,2c(-zf,
City (G -)5-6 k _ State "
f -7
ZIP '%%i,Z7 Telephon -/+ 3 113
APPLICANT'S NAME Last C712 mca First evS
Applicant's Address
Applicant's E-mail Address
2522 GRAV%4(414S (LO,,S loo
VA7-ARc(AGPAQOCLL.Nf:T
City-rus-nI...I _ _ State �-
Zip liz,7ba Telephon 7t4)3Y3 0303
ARCHITECT/DESIGNER'S NAME Last
First l�_ Lic. No. ( b (pQs'
Architect/Designers Address
Architect/Designers E-mail Address
j2522 CP► MFj6jC.S RO,) S,j+TE� IQo
VA1- A(L64 P_,PACBaLL .14ET
City 7uslo/yI _ State �A_
i
Zip ci 80 Telephone '7W)J 93 0-3 0.3
LJ
ENGINEER'S NAME Last FM O K' ildir
First �'AR� (L Lic. No. SC(.I 81
Engineers Address
Engineers E-mail Address
31fS 50, �14ST A''C-4UL`"�
-iAgE: K hc) 0H rA2 e_f,�(.. HK-N
City I (ipr(yMA (6fPC4 State (�A,
Zip q�S) Telephon ) 1.1q�,2777
No. (o(000 Class1P-j
CONTRACTOR'S NAME/COMPANY —r�D JS7/4-UCH (7.Ci dZCO Lic 3'7
Contractor's Address
Contractors E-mail Address _
14 CoRTo ko,
VAL-A2G(A G e*c 6 UL A. tE7
City I T'(21(1 HE, State f -�,
ZiplI q � I4- Telephone 74 37 3 03 b3
SETBACKS REAR �=— SETBACKS FRONT
\ D PERMIT NO. X zo lq)) - yr Vl'J
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. D M -'Ld l S
_��
USF 7oNE r1F\/FI (1PMFNT NO
C� O 'Z- (
PLAN CHECK FEES $ � � d � �
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
r- Comm'I Fz<Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
5[Building rGrading F-Drainage F-lec 5&ech VPlum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) [Flood Fire r Liq Landslide �N/A Floor Suite No
4,17 1 Mo(L sF-A
Description of Work
Use FiF D ConstType I l
j�pQIN 2 li 5F (i�t11t SNFfL 1�Cu�li #Stories # Units (if Res)s
Duwiv �Vk 12. ttir�%(C.13fa Roc�i`4 aN to � l.�`!A'%p�
F Valuation�y� ^
New/Add SF Remodel SF arage/New/Add Material/Labor ! f
OWNER'S NAME Last '37.t) LLB Firstl
Owner's Address Owner's E-mail Address
(? o. Pox 229 Z�, �
City (-�fk);5_e (i State T(-iW5 Zip / y-/ Z.2.7 Te
APPLICANT'S NAME Last C7OZ c fa
Applicant's Address
2522 cb�A�r(�is 1Z0., s�l'�� loo
CityI --rus-rH State
ARCHITECT/DESIGNER'S NAME Last F (,9Rp—L CO
Architect/Designers Address
25z2 el-�Y�wIP.�uts. R�•, 5,,,;� l�o
City UG-t li-(- - State
First I C-4uS
Applicant's E-mail Address
YAI - AR.cN G PAC31= LL . N E-r
Zip Telephon 714-) 3�3 0_ c63
First Lic. No. j CpQs
F q�s
Architect/Designers E-mail Address
vA.1 - A(-eN P eACSaU .14E
Zip qZ-7 0 Telephonek'71 _lri 93 03 03
ENGINEER'S NAME LastQK,lj/}First TAtZf-iL Lic. No.
Engineers Address Engineers E-mail Address
31(of5 SLR, &ram Fkcx-lvf-x-j Tj4(ZFICMokHrA2 UHKNk
Ciry I (� C<j'-1A (jf-` Pvc -i' State Zip C( Telephon ) 4 44, _ Z777
CONTRACTOR'S NAMEICOMPANY —r�� Lic. No. —Class
Contractors Address Contractors E-mail Address
—
City State I Zip F TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $