HomeMy WebLinkAboutM2016-0052Print Form Worksheet for Combo Building & Solar Permit Application �
City of Newport Beach - Building Division z�-' c
`."""' '— ""'�"'"� NOTE. PLAN CHECK FEES DUE AT TIME OF SU8
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F-Building 7 Grading 7Drainage Elec rMech
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(—Plum CuVdCm
Lilly
Project Address (Not mailing address) F_ Flood
(- Fire I— Liq F_ Lands' loor Suite No
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Description of Work
Use F7 Const Type 1
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�E PLACE FI�.[E EEL t tLES —.
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#Stories # Units (if Res]
$
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New/Add SF. Remodel SF�— Garage/New/Add �—
Valuation
Material/Labor a'IODO. �G
OWNER'S NAME Last IBRLBOA BA4 CLLJB _
First - -
Owner's Address
Owner's E-mail Address
laal f.3EST LGR-S F{t4lljL.)Rq _- — _-_—
City iAGL.)PGRT aERc-k{ State CR
Zip galoA3 TelephoneF—
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State �—
Zip _ TelephoneF
ARCHITECT/DESIGNER'S NAME Las-
First F— Lic. No.
Architect/Designers Address
ArchitecVDesigner's E-mail Address
_. - -.-- _--_--- .
City State
Zip Telephone
ENGINEER'S NAME Last f,1JtLLtRM !q/MP5D4 4 A55o,-r S Lic.No. g 3$la-_ _
Engineers Address
Engineers E-mail Address
a3 ORcttA2o 'Faso
rn�rl �cJsase.corrt
city LFtKE FpQEST" State CA
Zip rjgI,BD_ Telephone 9H17 ao�'9ga9
CONTRACTOR'S NAME/COMPANY
SNELLmAKEfZ
I,LI�. --- Lic. No. 61- 34 - Class RIB
- _- -
Contractors Address
Contractors E-mail Address
931 LJesi Ir7r14 S'T'kEET
Shellrnc ke��sbcyloba L.itet
City COSTA LrLF_ State GII
Zip Fqa ail Telephone 9H9 :g-S3Sy"
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. I�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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GENERAL REQUIREMENTS
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