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HomeMy WebLinkAboutX2018-0289 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application Comm'I Residential City of Newport Beach - Building Division o a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `'w•"" fiBuilding { Grading rDrainage ✓lec rMech F/Plum CuvdCut �— cuvdFill F Project Address (Not mailing address) F Flood (— Firer Landslide [_N/A Floor Suite No F F 1 L 1 b9 � ue,40, 1q Description of Work Use 51 F� Const Type �— # Stories #Units (if Res) RCG COkeI I. jljc,hVR 3 %a� 00rn Reri\ove v�ar becct�w walls�ce'I;hq Valuation Material/La rl�� New/Add SF1 Q Remodel SFr§)0 10 F14 F Garage/New/Add o OWNER'S NAME Last! ' I First[ SCO'�T / Amb�C HaS-c150� -- \aves4i•nen'fS Owner's Address Owner's E-mail Address 1 � 28 Colvice '1�o5�' Scoff@�tmb¢���t� P�oeer-'I-I e5.45m City_ FC-1)rY1e- /nl State � �. l� Zip CQ60 Telephone[ If APPLICANT'S NAME Last First CCCC� Applicant's Address Applicant's E-mai A(ddr�ess� i City i State F Zip �— Telephone�— ARCHITECT/DESIGNER'S NAME Last First Lic No. I� -Zjaj9 t"1 Architect/Designers Address Architect/Designers E-mail Address [ - __ 'City I - � IQrrGe �Qlac�rjrr�arl.Gpw� State Zip �— Telephone l0C(G(ct y-433 ENGINEER'S NAME Last First - Lic. NJ — Engineer's Address Engineer's E-mail Address I City State Zip F— TelephoneF— CONTRACTOR'S NAME/COMPANY Lic. No. 10 9_7 Class+ — S IUefS rvC' ConS4-t uG� pry Contractors Address Contractor's E-mail Address 2260 90sE Scoff �@ mb¢riea�'P�p�aj;e5,��1 City 1 f il � re _ --_- State- E CA Zip 1=9 2 6 03 Telephone,- I. ") �Zk_s SETBACKS REAR SETBACKS FRONT y V PERMIT NO. SETBACKS LEFT q SETBACKS RIGHT PLAN CHECK NO D USE ZONE DEVELOPMENT NO PLAN -CHECK FEES $ -