HomeMy WebLinkAboutX2018-0303 - Permit ApplicationiD;D3
Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
(" Comm'1 r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding rGrading [-Drainage i—Elec r-Mech F-Plum cuvdcuf CuvdFill F
Project Address (Not mailing address) F Flood F Fire F- Liq F Landslide F _N/A Floor Suite No
Doscriptionppof Work Use �, ConstT pe
17 uy*'(� Li D LI- T T
# Stories #Units (i
Valuation $C-3
New/Add SF�— Remodel SF �— Garage/New/Add–� MateriallLaU U
OWNER'S NAME Last First
Owner's AddressOwner's E-mail Address
t 4 2 60 oc Aor
City —r5 State �..ty. ..Zip 4� Telephoned
APPLICANT'S NAME Last First
Applicant's Address Applicants E-mail Address City F.
State G Zip Z�, Telephoner
ARCHITECT/DESIGNER'S NAME Last First �— Lic. Nof r
Architect/Designees Address Architecvbesigner's E-mail Address
City State �— Zip �— Telephoned
ENGINEER'S NAME Last First Lic. No.F— '
Engineer's: Address Engineer's E-mail Address
City State �— Zip F— Telephoner
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/ CONTRACTOR'S NAME/COMPANY S Lic
� ,--w t.No. '�'j�,p9 Class FT '
(� Contractor's Address Contractor's E-mail Address
r .� . ik� .
CityStafe 6�p-���Felephon
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'SETBACKS REAR SETBACKS FRONT PERMIT NO. V
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.