HomeMy WebLinkAboutX2016-0520 - Permit Application7'HAL�� �2,M- O �Wo sheet for Combo Building & Solar Permit A pH ation
V,Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
M.uilding rGrading F -Drainage j-!Elec rMech f-, Plum cuvdcutF— cuvdFill
Project Address (Not mailing address) ri Flood r Fire r Liq r Landslide rN/A Floor Suite No
Description of Work
Use Const Type F_ ;
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U) 7,34CLTI-L Q \ M (�
#Stories �, ,' #Units (if Res)
Valuation $
Material/Labor4;; D t v
New/Add SFF Remodel SFF— Garage/New/Add
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
CityI / n4..iJ G',h !; State —, Z;p a eF_..
APPLICANT'S NAME Last ( o st p
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Applicant's Address A licant'aE(- iAddress
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State Zip ql 2�Z �j Telephone g
City S.,,tYC
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ARCHITECT/113ESIGNEA NAME Last �' t FirsLic. No. F
Architect/Designer's Address Architect/Designer's E-mail Address
City _ _ _ State Zip F Telephoner
ENGINEER'S NAME Last First `��� I First F Lic. No.Fj
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Engineer's Address Engineer's E-mail Address
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City Mc ry016_ . State Zip (p? Telephone 6 -3 J
CONTRACTOR'S NAME/COMPANY 6x1(;5 cLic.N�rof. 7 I ClassG� xj
Contractor's Address Contractor's E-mail Address °,/ t ��1
City 5l#v— f EEG3C9 J State Zip �(�� Telephone �_✓ 6
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SETBACKS REAR SETBACKS FRONT PERMIT NO. Q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $