HomeMy WebLinkAboutX2017-4078 - Permit Applicationl �� Z8 -4-s IV - Kso1-4-- 410:f 6
I 1Q.,,. `RR Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
-Building -,Grading -Drainage -Elec -Meth r ,Plum CuvdCut� CuvdFill
Project Address (Not mailing address) - Flood - Fire Liq - Landslide -N/A Floor Suite No
2-8 Vier EL _. 1 _ F_ F_
Description of Work Use F—ConstType F_
17LO I .rFLow Abbi7i A RV+10tleL kiTckenl } Nw®ay i�ArlAp Nest
t #Stories njts-fif�Res I�
to � ►S NttC;csa�s� aa��Fsr tJ�wcRcAG� s�AAt 5 N�wwiN4uudS.4e04r5
Valuation
New/Add SFj" {A Remodel SF r € Garage/New/Add Materi /Labor IIJJ
OWNER'S NAME
Last _QrUi (a S First 01:) A ( At ZS!
Owner's Address Owner's E-mail Address
�f/7d W66--�I-eY /CnwcP IZO �S�o
City (fo" N/y State C 4 Zip 9299 ( Telephone (q,'9) tfS 4 1 S7
APPLICANT'S NAME Last (:;j0(€2ejU &04e (,76NS#,, First
Applicant's Address IApplicant's E-mail Address
/S'm ,pvt Qoa6c- , i/ elm+ "i vw is Ciocs7enrEaG�cvMs,s ✓c,.o,v. c,,•,
City {yUNinlyiiln% f eblGty State CK} Zip 9y6yq Telephone i7i , P97 -o971
ARCHITECT DESIGNER'S NAME -
Last1clUL{7vw4airstI..,.. Lic No.F--'....
Architect/Designer's Address Architect/Designer's E-mail Address
y,yyy
City State Zip F� Telephone-,
ENGINEER'S NAME Last /Z e -Z,4 /' First FFAA/M /3 Lic No. e- 39 ao
Engineer's Address Engineer's E-mail Address
/0231 S4,41-par/_eaye 201 -yC00t �+x e_COAS-reA r. cast
City €? Jrtx',grP/ E% 1 �ta + State Zip I 1270 Telephone ('fid `Pj CY 3 a 0 3 a 7
CONTRACTOR'S NAME/COMPANY i CN a (9CU/V 5 i /LUtC -r, JN Lic. No. Fe-oo077 Class a-,
Contractor's Address Contractor's E-mail Address
/ssg/ _'noDUG! LA/ Sur _I Mc.gcy �0L_bC,
tQL0INCa M7;/Lt/bdroa,6
City aU%iN
N f 0!i/ �C•.1f:G/j State �/T ; Zip '?1 Z.4 _ Telephone. N) ��7 - 0 tai7
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1
VK -ZONE DEVELOPMENT NO. PLAN CHECK FEES $ ! l
1