HomeMy WebLinkAboutX2018-0543 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I r Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading [—Drainage rElec rMech r Plum Cu YdcutF Cu Yd Fill F
Project Address (Not mailing address) F7 Flood r" Fire F_ Liq F_ Landslide FN/A Floor Suite No
Description of Work
Use Const Type
QNy l��M
# Stories # Units (if Res)F_
Valuation S
New/Add SF I Remodel SFF— Garage/New/Add �—
Material/Labor
OWNER'S NAME Lash First �.���–T 7%)P(7
Owner's Address Owner's E-mail Address
(412 t_:. ocFi?V PANT ,dlq'roercA �[�vtAi caws
City JZ jsy/j�¢ ., _.. State �— Zip � Telephone
APPLICANT'S NAME Last GfAI �/��� First
Applicants Address Applicant's E-mail Address
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City ��C–"r Z3j State Zip&4,,) Telephone 9 2%
ARCHITECT/DESIGNER'S NAME Last 'A "Qt -0 First f Km i Lic. No. F3 •
ArchitecUDesigners Address Architect/Designer's E-mail Address
2/ 7EPFPN /yoAp #
City WH� «� State C14 Zip 1 706 Telephone •q ' •36q'(o
ENGINEER'S NAME Last J , S . 9-/0 N First 7— Lic. No.7
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CITV "Z -
Engineer's Address Engineers E-mail Address
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City (01-1177 � .. _ _ State Zip j tiO
gQ�pQS Telephone o •9%/ • � % '
CONTRACTOR'S NAME/COMPANY f� $ Lic. No. �— Classr—
V
Contractors Address Contractors E-mail Address
-- Zip Telephoned
City State --
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. i/4/R' D��! �i•
PLAN CHECK NO. 0 L/
USE ZONE DEVELOPMENT NOS J_,SVI.9 PLAN CHECK FEES $