HomeMy WebLinkAboutX2018-2330 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Q
�I Comm" X Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) ri Flood I-1 Fire 17 Liq F7 Landslide I —N/A Floor Suite No
Description of Work 22
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# Stories7�l # Units (if Res)
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Valuation $
Material/Labor 00 o
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OWNER'S NAME Last Swe x ne �'I First ��
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Owner's Address Owner's E-mail Address
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City
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APPLICANT'S NAME Last.; ^ Q First 2�
Applicant's Address Applicant's E-mail Address
City State Zip F_ Telephone
ARCHITECT/ IGNER'S NAME Last ',, First �I
Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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City N � ',. State �� Zip Telephone
ENGINEER'S NAME last First FI Lic No.F
Engineer's Address Engineer's E-mail Address
City I j State �— Zip F_ Telephone F_
CONTRACTOR'S NAME/COMPANY / C =t Lic. No. ri bz TLo! Class'
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Contractor's Address Contractor's E-mail Address
City �(/,C f o-t /,c_.L State cam} Zip S-Z6(,.. Telephonect..tS_`' 1-3L-n:)
SETBACKS REAR SETBACKS FRONT PERMIT NO. / 1 �fj1—Z7jr�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO �� PLAN CHECK FEES $—r+2--�—
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