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X2015-0577 - Permit Application
Y\' LF PGS 6eC/k0 ©qSg — _Z&)5 201�-pI$`� 57? � 3©L � P&rm t T— 6t-- ><-z�v t � —05_7'7 y f Worksheet for Combo Building & Solar Permit Application 04'." City of Newport Beach - Building Division r Comm'1 ^ Residential un=- Di Ani Pwrrw FFFS Ill IF ATTIMF OF SUBMITTAL F -Building I Grading rDrainage F_Elec j-Mech F- Plum cuvdcutl cuvdFill l Project Address (Not mailing address) [ Flood F- Fire F- Liq F_ Landslide [N/A Floor Suite No Description of Work Use F Const Type # Stories, — # Units (if Res) S� 9naa f3 C JclL a 4 GL Ga/ISi % "cc --r let i9 CCOP�/?li! s ec I GIG i f O� M Valuation $�QDQ-� Material/Labor �_ _ New/AddSFJ— Remodel SFGarage/New/Add OWNER'S NAME Last (.{/At - Firstl Owner's Address SN/8c� c c c Owners E-mail Address _m,4)4. d57 VIA �a,sai�l C�2ec cd City S-„ C State Zip gZ( 7:� Telephoner J�S�OD APPLICANT'S NAME Last 0 Al First o2(/ Applicant's Address Applicant's E-mail Address �Ai✓i Z l S iNe City State Zip �— Telephoned ARCHITECT/DESIGNER'S NAME Last First �— Lic. No. �- Architect/Designers Address ArchitecNDesigners E-mail Address qty - - - _ -- - -- - State �— Zip �— Telephoned _ r— ENGINEER'S NAME Last I First Lic. No.+ Engineers Address Engineers E-mail Address �--` City l State Zip �v TelephoneF_ CONTRACTOR'SNAME/COMPANY�k�ht9rb /�tL2✓t CO��fCZan Lic. No. ro3y�%�Classa Contractor's Address - City - State F_ dip Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. �Q SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ' U5EZONE _ _ pEVELOPMENT N0 PLAN CHECK FEES $