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HomeMy WebLinkAboutX2017-3567 - Permit Application�k 1 Y2,011- 3GI-e 1 \ Worksheet for Combo Building & Solar Permit Application o4�EW F- Comm'IResidential City of Newport Beach - Building Division o d NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G��.•" Building Gradin Draina a Elec Mech Plum Cu Yd Cut Cu Yd Fill j 9 9 9 - Project Address (Not mailing address) F.- Flood Fire F_- Liq F-, Landslide CN/A Floor Suite No Description of Work hs Use N3. Const Type # StonesT #Units (if Res)rf� �hrbGztanp1498 Pv� o D1uu x� .//!due i" e t,?t?d_��/a�� Valuation © j Material/Laa bor ' New/Add SFF! RemodelSF� Garage/New/Add OWNER'S NAME LastAC /JF�k L �I�', First r /�C� Owner's Address Owner's E-mail Address City i)o/�—��� _. State Zi '�', Telephone APPLICANT'S NAME Last First -_ WeA re- eApplicant's Applicant'sAddress Applicant's E-mail Address City _ -- - -V i „'1 wf 66? / State Zip �6 Telephone W ARCHITECT/ /DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City _ _. - -._- State F_ Zip. Telephoner, ENGINEER'S NAME Last First Lic No.F_1 - Engineer's Address Engineer's E-mail Address City State Zip TelephoneF CONTRACTOR'S NAME/COMPANY Lic. No. r --I Classr� Contractor's Address Contractor's E-mail Address City State F_ Zip r— Telephoner SETBACKS REAR SETBACKS FRONT PERMIT NO. 5 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �1 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $