HomeMy WebLinkAboutX2014-2996 - Permit Application (3)I
Worksheet for Combo Building & Solar Permit Application
(° Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building FGrading F-Drainage r,Elec F_Mech FPlum CuYdCut
1-7 CuydFill F-1
Project Address (Not mailing address) C Flood [ Fire Liq Landslide N/A Floor Suite No
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Description of Work
Use FI Const Type
# Stories # Units (if Res)
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\ C', G C4
Valuation $
Material/Labor l (/
New/Add SF - Remodel SF L(r� Garage/New/Add -
OWNER'S NAME — _/- J First
Last 1jiS_Q� . � e f Gi Iwi1 [ 5` i h
Owner's Address - _._- - __ _ - -. - Owner's-E-mail-Address-- - - -
� 2�1-- �fo�_ _� ,rr v� GcP- -� fio .R; a MFC CorJ t Co
City etA) eo fl - eOC State _ Zip Telephonedd i
APPLICANT'S NAME Last ( First
Applicant's Address Applicant's E-mail Address
City State Zip � Telephone _ l
ARCHITECT/DESIGNER'S NAME Last _1 First _ Lic. No.
Address Architect/Designer's E-mail Address
City --- - - J State Zip [-- TjElephoneF _
ENGINEER'S NAME Last ! _24t First c -I
Engineer's Address Engineer's E-mail Address
City - - - - J State [__ J Zip F Telephone
CONTRACTOR'S NAME/COMPANY j��ic.No. �ZZ Classl J
-�- M
V tuC, l�
Contractor's Address Contractor's E-mail Address
City q M PGt�S ( State Zip -70 Telephone r s SS
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SETBACKS REAR SETBACKS FRONT PERMIT NO. Xg Dlq - Z91 "1(0
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $