HomeMy WebLinkAboutX2018-3460 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Mudding F Grading F-Drainage F Elec F_ Mech
(- Plum Cu Yd Cut Cu Yd Fill F_
Project Address (Not mailing address) F_ Flood
F_ Fire F_ Liq F_ Landslide FN/A Floor Suite No
2b I5 A4 A `nsrA Off., New
6-eQL4 I
Description of Work
Use K'1/U ConstTypeIV-6
#Stories #Units(ifRes)[—
UoIL(t+fW1_a' CILMC fVt�Ar'!'0n ��.O�G�/rn�
Valuation 5
Material/Labor
New/Add SF 13r � � Remodel SF / Z64-- Garage/New/Add F__
OWNER'S NAME Last
lJ
First
Owner's Address
Owner's E-mail Address
Cityeo,e l,, State
Zip II Z 6{- Telephone (T() jZO_
APPLICANT'S NAME Last ��Mpr„
First I 51kve"
Applicant's Address
Applicant's E-mail Address
1411 �. 4a
Be,l-p-, , 4� e. US
cde� e44 tV e2p�/Ps� �v,c. corms
City Of•�!!•h I,� State
Zip 9�'67 Telephone */k/ 3w-oge-,
ARCHITECT/DESIGNER'S NAME Last r First F9ev� Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
4/ N• 94k,,AG Ste. �lS
7lwCiLr A sr(PdPs� nc� C!
7
City State
Zip q Telephone �7i4/
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ENGINEER'S NAME Last �yl �,�
a 0 - `
First Lic. No. C?j ,� 5_7
e
Engineer's Address
Engineers E-mail Address
P (). Avy =+
City „p State C-
Zip G%j Telephone
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CONTRACTOR'S NAME/COMPANY 44UN3(� ( cep -fjl� Lic No. qW OCi Class
Contractor's Address
Contractors E-mail Address
q?-�(Z 1--t
city l,Vy- L n &C-CA State FCT-
(j
Zip T (f,(, Telephone iv
SETBACKS FRONT
PERMIT NO.
SETBACKS REAR
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ t 1