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HomeMy WebLinkAboutX2017-0183 - Permit Application�Zo17-ojg2� Works_ eet for Combo Building & Solar Permit Application City of Newport Beach - Building Division F comm" `Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL w .o... Building F_Grading!nage (-Elec F_Mech F- Plum Cu Yd Cut Cu Yd Fill F-1 Project Address (Not mailing address) F_ Flood F_Fire F Liq F_ Landslide FN/A Floor Suite No F J Description of Work Use F Const Type F # StoriesF_ # Units (if Res)F a u tion $ liq Al New/Add SFF Remodel SF i Garage/New/Add l La r !l 000, OWNER'S NAME Last At,�(j ) C� First G� Owner's Address Owner's E-mail Address '� `� t3' 05 X10 l cAf_ 3 t , LID" ' City ?� j •{.�- _ State a� Zip Telephone �3,0 • APPLICANT'S NAME Last First AL`G\�_ Applicant's Address Applicant's E-mail Address 2A0[ (rA-R_03 -5T-LAX c �LCfiV�G( Cvj , l t7rv� _ city f5-... City `070- State _ Zip I' lf� �jo - Telephone 3l(} .F • '� ARCHITECT/DESIGNER'S NAME Last First F Lic. No. Architect/Designees Address Architect/Designer's E-mail Address City State Zip F Telephoner Q ENGINEER'S NAME Last lrl �bf �L_ _ _ ir8t `G� I L S 1�e� Lic. No: S4-2o� i -,Vr�q ` ' ' Engineer's Address `c Engineer's E-mail Ad City l/ ,l,l 7�c _--_- State Zip iJO'-J- Telephone � 6V,.g5`7JV,,. �3c)G O _ CONTRACTOR'S NAME/COMPANYClass iKeNo. �If 11-1 1 4 GLOUeK G wp LA ql1 nContractors Address cr Contractor's Email Address I 5 3 - v� AI Po4�r•Ky a ,&.0�A City - a StateZip Telephone f a/5/ qqo Sr s SETBACKS REAR " SETBACKS FRONT 61 PERMIT NO. SETBACKS LEFT 520 SETBACKS RIGHT PLAN CHECK N USE ZONE -- DEVELOPMENT NO PLAN CHECK FEES $ �I 61