HomeMy WebLinkAboutX2018-3464 - Permit Application)C,'101g0 - 7oA4 01-4
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I rResidential City of Newport Beach - Building Division n
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(X—Building rGrading
rDrainage rSElec rMech r, Plum CUvdCut F CuvdFill F
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
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Description of Work j-oy\ _(' ct\kAkh+u
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# Stories', # Units (if Res)
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Valuation $
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New/Add SF
Remodel SF 1 2 -7 F5 Garage/New/Add
Material/Labor
OWNER'S NAME
Last First Qu sh ath& Eve,
Owner's Address
Owner's E-mail Address
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City I N Q, Po X—M;K State CA Zip F_ Telephone g'Q _() & — 5L(k3
APPLICANT'S NAME
Last Richart First Jason
Applicant's Address
Applicant's E-mail Address
1041 W. 18th St, (Al 06)
Jason@richartdesign.net
City Costa Mesa
State CA Zip 92627 Telephone949-422-9191
ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. �—
Architect/Designers Address
Architect/Designers E-mail Address
1041 W. 18th St, (A106)
Jas�richartdesign.net
City Costa Mesa
State CA Zip 92627 Telephone 949-422-9191
ENGINEER'S NAME
Last JAMIL First Bashar Lic. No.F_
Engineer's Address
Engineer's E-mail Address
751 SHASTA DRIVE
city (CORONA, CA
State FA Zip F Telephoner
CONTRACTORS NAME/COMPANY 1J ACLIc. No. Class
Contractors Address
-7(D92. 'i i,
Contractor's E-mail Address _
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City �_FF
State Zip �z 4�/ Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $