HomeMy WebLinkAboutX2018-3288 - Permit Application01m/-2,()/9
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Worksheet for Combo Building & Solar Permit Application
F- Comm'[ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) C Flood F_ Fire F_ Liq [ Landslide [N/A Floor Suite No
Description of Work
Use T� V1 ConstType
# Stories. # Units (if Res)r
Valuation $
New/Add SF (U Remodel SF O Garage/New/Add
Material/LaborFID
OWNER'S NAME Last ;�
First Fj:aW ` LeAl p��
Owner's Address
Owners E-mail Address
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City - State
Zip � Telephone
APPLICANT'S NAME Last - '�' /+ V First
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Applicant's Address
Applicant's E-mail Address
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City _ - T/ -I c�!/ V�-_ State �
Zip J. ZY (O U ' Telephone J H 9 S 3 3 J 8
ARCHITECT/DESIGNER'S NAME Last
i First Lic. No.
Architect/Designers Addrr+ess.
Architect/DefgnerE-mail Address
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State �(I
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Zip Telephone.-� CJ
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ENGINEER'S NAME Last
First; l `G kl� Lic. No. U4
Engineers Address
Engineer's E-mail Address
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II-Urla�-YI-3e�
City -� D) Dr-- �-ri b State ��
Zip � 2 �� l Telephone J � 24 f[ - 1/6
CONTRACTOR'S NAME/COMPANY
Lic. No. �—V Class—o
.
Contractor's Address
Contractors E-mail Address -
_ -I
X 2,010
City _ State F77
Zip Telephonel , —
SETBACKS REAR SETBACKS FRONT
PERMIT N01 81
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. lr L
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $