HomeMy WebLinkAboutX2018-3374 - Permit ApplicationPrint Form Wor et for Com ao Building & Solar Permit Application ozEw�R>
F-Comm'I F_ Residential I ' > City of Newport Beach - Building Division
NOTE:
I 000 PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading rainage F_ Elec r Mech F Plum Cu Yd Cut F. Gu Yd Fill
Project Address (Not mailing address) _ Flood r Fire F_ Liq F_ Landslide /A Floor Suite No
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Description of Work
Use ;; -J ConstType
StoriesF # Units (if Res)
valuation $
Material/La
New/Add SF /-[_s-- Remodel SFF, ., Garage/New/ dd / j
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OWNER'S NAME Last ?rn I� First 041 1 rr
Owner's Address
Owner's E-mail Address
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City NZ -QC State C Zip '�� 3 - Telephone
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
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City ,F��F�,-,_._,; State [;',q Zip `J• j'?o Telephone
ARCHITECT/DESIGNER'S NAME Last First,/ Lic. NJ-
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City � State F_. Zip F- Telephone
ENGINEER'S NAME Last Ob.J First Nad; 0 Lic No. ��fraC rC
Engineer's Address Engineer's E-mail Address
City Jy " _eueQ.G/� State r-C Zip i Telephone f 0 f
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CONTRACTOR'S NAME/COMPANY tL� `�,/ /� [< Lic No. Class
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Address Contractor's J ' il K1
Contractor's E- ail Addr ss
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City Hrctt�4 nfcLulC State �� Zip F)gt6igY Telephone W OCY. (6y467
SETBACKS REAR SETBACKS FRONT OGL PERMIT NO. 06 1b a
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. - ti
USE ZONE DEVELOPMENT N� L PLAN CHECK FEES $