HomeMy WebLinkAboutX2016-2546 - Permit Application175&-2oh,
Worksheet for Combo Building & Solar Permitapplicaion
❑ Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[$uilding ❑ Grading [Drainage lec < ech I Plum Cuvdcut[ Cu Yd Fill
Project Address (Not mailing address) n Flood ❑ Fire [] Liq ['Landslide FIN/A
awl If 9 2 &1.9.
Description of Work
2� 47
&m e/0f4J Jn}a! I afi
New/Add SFL
OWNER'S NAME
Owner's Address
City
Floo
FO
Suite No
Use [
ao,
Remodel SF.,�f'�' Garage/New/Add
Last
1 »?2ag Dr/ (/e 8k 4i U,v
li/ew/9U✓*' alack1 State
Firs
Owner's E-mail Address
Storie
Elk
Valuation $
Material/Labor
Const Type
N Units (if Res)
%'50 /<
gag . 6 ao oK s 6.9 A o4 q .6044
Zip Telephone94/9 (95Q92
APPLICANT'S NAME
Applicant's Address
i H loob fr ll/c//11 kel 4,94
State p"A
City
LA At
33-
JFirst L
Applicant's E-mail Address
ee(�R11 t5Coc.DI/CalS,Odos
pp/ /v(.). Telephone 9/./-6,j%j-'6vOU
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
Last 7r3t
L/ g/0oo ' clrd ' /
cgs
City .fA",
State
I-
/) Zip
First Kt.
Architect/Designer's E-mail Address
Lic. No. Ls
"'Nag r5 e-o 9 Yet: su t Q
Telephone
940-479-6 db
ENGINEER'S NAME
Engineer's Address
Last
City
State
Zip
First
Engineer's E-mail Address
Lic. No.
J
Telephone
CONTRACTOR'S NAME/COMPANY
Last Lyn., C4
Lic. No.
Lit I`�T- C EL_fl Y C o n17/�r'.�Lb
Contractor's Address _ Contractor's E-mail Address
tl 'E>----riare_ \,'41 t (��
City
Co_La. r-±a_
SETBACKS REAR
SETBACKS LEFT
USE ZONE
State
RSBd jClassB i
/"S'i r a� �,r�rr LlC ii xuiufltcoLzr ne-Th"' CAM
Ip 92PF37
Telephone
SETBACKS FRONT PERMIT NO.
9 9 205 6,',O'
,5i?%
SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $