HomeMy WebLinkAboutX2018-3849 - Permit ApplicationWorksheet for Combo Building & .Solar Permit A plic tioll
r" Comm'I Residential City of Newport Beach - Building Division
NQTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F— Grading l rainage Elec F-Mech
PIun3 Cu Yd Cut Cu Yd Fill
Project Address (Plot mailing address) Cf Flood I` Fire r Liq F Landslide IVN/A Floor Suite No
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Use F ConstType
#Stories; #Units (if Res)��
'C V,_ '�
FJEt r.� -.
Valuation $
Materlal/Labor — l
�`�`�
New/Add SF[ dl Remodel SF Garage/New/Add I I
OWNER'S NAME Last �y� _
_ First ' ALL
Owner's Address
Owner's E-mail Address
_
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City 0 '( ��[�' State �
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/_X:
12A(,/ Tetephone �M 2 l—'
Zip [1124(,
APPLICANT'S NAME Last �
Firstr
Applicant's Address
Applicant's E-mail Address
City r-'"�1L--.tQ State ��)
Zip -�Z�-' Telephone "�ip 7• .j
ARCHITECT/DESIGNER'S NAME Last
First L, i Nh Lic. No.
Architect/Designer's Address
Architect/Designer's E-mailAddress
City �Oa� ��, "` State CIl �
Zip tTelephone %�'�'{, 23,25
ENGINEER'S` NAME Last
First I Lic No.F—
Engineer'sAddress
Engineer's E-mail Address
_
v;'
State F
city F /
Zip �� Telephone���
CONTRACTOR'S NAME/COMPANY I '�.A �rA.-a9�G, (2_ uy�Lic.No. b1l,, Class '2%
Contractor's Address
Contractor's E-mail Address
City _ _ - _ - ,L, � _ State I'" _
Zip I "'& C S Telepho �� (f(?•Zj
SETBACKS REAR �\ SETBACKS FRONT
/
70 PERMIT NO. `"1
SETBACKS LEFT SETBACKS RIGHT
S PLAN CHECK NO. SOT
-�_-
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ L /
Print For Worksheet for Combo Building & Solar Permit Application St
F_ Comm'I City of Newport Beach - Building Division
r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-`Building ( Grading rDrainage j_Elec Mech rPlum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) f Flood �t Fire F-Liq F_ Landslide F_N/A Floor Suite No
��t p 1 f
Description of Work
Use F—Const Type F
4 7
# Stories[ # Units (if Res)
Valuation $
Material/Labor
New/Add SF�— Remodel SF Garage/New/Add F—
OWNER'S NAME Last e�diA ,�-3 First M,\L
Owner's Address Owner's E-mail Address
City I �GC.� �j[ State 7-K Zip Telephon b Z Z
APPLICANT'S NAME Lasf First vkLL-A- tZ7�
v
Applicant's Address __`J\ Applicant's E-mail Address
City ii��`pp._.l_ State �� Zip 12L Telephone �`t -10 C -7"3
ARCHITECT/DESIGNER'S NAME Last �— First I� Lic. No. F—
Architect/Designer's Address Architect/Designer's E-mail Address
City I— State �— Zip F_ Telephoner -.-.
ENGINEER'S NAME Last � First F_ Llc. No.F—
Engineer's Address Engineer's E-mail Address
City State �� Zip F TelephoneF—
CONTRACTOR'S NAME/COMPANY Lic No. �— Class
Contractor's Address Contractor's E-mail Address
City State � Zip �� Telephone[ —
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
Print Form Worksheet for Combo Building & Solar Permit Application n4w
F_ Comm'I Poesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building I— Grading
I —Drainage F_ Elec I— Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F_ Fire f— Liq r Landslide f N/A Floor Suite No
t
Description of Work
Use Const Type
Ll V3,eV,
# Stories7 # Units (if Res)[_
Valuation $
Material/Labor
New/Add SF �—
Remodel SF Garage/New/Add
OWNER'S NAME
Last First
Owner's Address
Owner's E-mail Address
City New 7
1
�'� State Zip — Telephone 241912-T
t—Last
APPLICANT'S NAME
i�. b
FirstApplicant's
Address
Applicant's E-mail Address
1LL027A . PST
City State Zip [I'�i ..Y� Telephone q 73
., 5eyb
ARCHITECT ESIGNER'S NAME Last F First j'lltl'Y ttL__ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
city
State State IC../'1 Zip Telephone7G
ENGINEER'S NAME
Last i t Lic No.F—
Engineer's Address
Engineer's E-mail Address
City
State �— Zip �— TelephoneF_
CONTRACTOR'S NAME/COMPANY LiNo. —Class E
4 N�
Contractor's Address
Contractor's E-mail Address
23 2D 2_kz,7
y
o c_ �.. ilrak K: ' C��
City 6
Staterzl� Zip � ZL.Z Telephone �Tf 17 Z,j(:i�
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $