HomeMy WebLinkAboutX2018-1043 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
Comm'I J�LResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(Building
F_ Grading rDrainage
Elec [-Meth C- Plum cuvdCut I
cuvdFiu
Project Address (Not mailing address) F Flood F_ Fire r Liq (- Landslide
F_N/A Floor
Suite No
New/Add SF a � � Remodel SF [ Garage/New/Add
Use F_
Const Type F_
# StoriesF— # Units (if Res)F—
$ o7 - 00
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OWNER'S NAME Last 6Zy � A-nhjd j Flrstl Sz,f� J am`
Owner's Address N Owner's E-mail Address
City Ne State F &4 Zip 1;0?GG() Telephonel3�u�-Fo3Q
APPLICANT'S NAME Last I ll /.� A 46P"% First I u t in
Applicant's Address
3419 (Jr� G;U ffa33
City Ne W pJ L. e State I N4 —
Applicant's E-mail Address
�cjX-, Nef-
zip p
I (_Ti 3 Telephone ��T -,3� •- _37oo
ARCHITECT/DESIGNER'S NAME Last 6 de AJ l- ` First /�' I[ y Lic. No. L 7 3 3 1
Architect/Designees Address Architect/Designers E-mail Address
/'Q/G State C,�} Zip /�b6U Telephone[ 3/ 6 , ( 09,P
City
New(>0 I
ENGINEER'S NAME Last G e N (-L First c-i"' Y Lic. No. 33 f 1
Engineers Address Engineers E-mail Address 1
l?U� Po S ey Pi, I--
City IV 2 w t�P.� State �- Zip (�' �D6 Telephone) �/I V _ 6 7 -y U / d%
CONTRACTOR'S NAME/COMPANY N �N' /+�� Lic. No. ljoi0 Kj ClassF 13
Contractors Address .� Contractors E-mail Address
�33
city N�4.i�J.¢/} State (,'�} Zip RZ6�3 Telephone) 7! 33 7-
SETBACKS REAR SETBACKS FRONT �� / PERMIT NO. 'xZCi th " I,l/`"I�
SETBACKS LEFT S SETBACKS RIGHT r PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $