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HomeMy WebLinkAboutX2016-4249 - Permit ApplicationW hee for Combo Building & Solar Permit Application F-,, Comm'IResidential 1 City of Newport Beach - Building Division C Cl NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -!Building [,Grading rainage ❑Elec F-Mech [-;Plum Cu Yd cut Cu Yd Fill 17 Project Address (Not mailing address) ❑Flood [°; Fir �N �I Landslide 1 -N/A Floor Suite No It lea 15 + 1 015 L t7nL&^ t3l.v 0. V,/ Description of Work Use [-) Const Type F -I # Stories #Units (if Res) F Valuation $ r New/Add SF / Remodel SF Gara a/New/Add I SF FI g Material/Labor y 5 0. OWNER'S NAME Last t,^u/oa,2.✓IA-uw i First LkN C.LE- Owner's Address Owner's E-mail Address as � L'i�IFJ'71 �r✓/u� ^�l �V' _ �G`7CP 1Gl U% C✓C SJe-�'� �. City IiAsW r !k t /L W �y J State ! " ZIp g 2-v l _ I Telephone 3t 2 9oi -7 9 -t -7J L _ APPLICANT'S NAME Last LA A0, Le,01LC First LI�NC Applicant's Address Applicant's E-mail Address City ( State i ZIp I Telephoned ARCHITECT/DESIGNER'S NAME Last F First Lic. No. r Architect/Designer's Address Architect/Designer's E-mail Address City State ZipF_j Telephone—ll ENGINEER'S NAME Last FirstLic.Lic No.F— Engineer's Address Engineer's E-mail Address City State F Zip I Telephoned—' - — — CONTRACTOR'S NAME/COMPANY Lic. No. �— Class Contractor's Address Contractor's E-mail Address City State E77 Zip Li Telephoned - SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.�,• USE ZONE DEVELOPMENT NO O • I PLAN CHECK FEES $