HomeMy WebLinkAboutX2018-3221 - Permit ApplicationPrint Form At 3rksheet for Combo Building & Solar Permit Application 05t
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F_ Comm'I j— Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 4�„0.+"
r[:Building F_ Grading [—Drainage f—Elec �'-Mech Plum Cu Yd cuts Cu Yd Fills
Proje dress (Not mailing address) [_ Flood F_ Fire r Liq r Landslide rN/A Floor Suite No or
Description of Work Use 1, y.r�"ConstType S{ fit
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1 ( - # StoriesF� #Units (if Ress
Valuation $ l ®Q�
New/Add SFs Remodel SF� Garage/New/Add Material/Laluor
OWNER'S NAME 666' /`` // / _ First Last .+"� � ���� 1JJ�Y (,✓ � -.
Owner's Address I Owners E-mail Address
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City :i7(zViA/r, -_....... State Zip-- i70 I Teell7ephone g47i--
APPLICANT'S NAME Last ! First I1rizK
Applicant's Address Applicants E-mail Address
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City State ( Zip q 2" L— 1 Telephone
ARCHfTECT/DESIGNER'S NAME Last 1 ' ����Ir First / ���M (s Lic. No. G
Architect/Designer's Address Architect/Designers E-mail Address
city _',Ifwrzr t34%&O State �h Zip ' L"�%"�-C/ Telephone
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ENGINEER'S NAME Last First F_ Lic. No.F_
Engineers Address Engineer's E-mail Address
City State �— Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY Lic NaT� Class
Contractors Address Contractor's E-mail Address
City State Zip �— Telephoned— - -
SETBACKS REAR SETBACKS FRONT PERMIT NO. X zot —'SZ-
SET8ACK5 LEFT SETBACKS RIGHT PLAN CHECK N0. ;7j51 1
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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