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X2014-3358 - Permit Application
7__�7 Print For Worksheet for Combo Building & Solar Permit Application Comm'[ j- Residential City of Newport Beach -Building Division o f NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL BuildingGrading IktSrainage 'KElecMech KPIum cuvdcut ,5Q Cu yd Fin JQ Project Address (Not mailing address) r Flood f- Fire ri Liq r Landslide rN/A Floor Suite No r �— Description of Work Use FAT onstType Stories#Units (if Res)I— �I A H t_U) F-:, u I L.21 rJ& aJE.Xlsrali,� S im (,�/ Valuation $ 3 RJ( -Q 6-p,Ortm Material/Labor New/Add SFF5_&,490--' Remodel SFF; Garage/New/Add F OWNER'S NAME Last yog1 , First HA-r<K Owner's Address Owner's E-mail Address 1*01 i1ji!E5zcLzFr, 1P,P./ve /4APKYCI° RNDlGKo6o'V City KIIj� - State (fA Zlp qZ,,, _ Telephone%/`L.CI� !First APPLICANT'S NAME Last Y� N�4 Applicant's Address Applicant's E-mail Address I/#* H, ©milli_C5 , -4Hi HNN�;gec-7 ?—=cTso g A 84 P t foM _ City Di State I Cell Zip C�ZB�'� Telephone [ First ;2 ak-F Lic.No. IEZ375''7 ARCHITECT/DESIGNER'S NAME Last $�p��Z Ar�cfhititect/Design//ees�Alddress Architect/Designer's E-mail Address CON FWAI, AI, D/�?wa,, s7- ,- ��,f� li7r(� ��1.'�i/%.����0�' a CO -City State �- Zip Telephone 7/ /d?�Q g5o ENGINEER'S NAME Last -<,4R X1,5 FirstLic. No: 036 Engineer's Address .Engineer's E-mail Address 1,203,91 /A?,E FOREST RK lV E� 5()la B/57 �IK'I�I S ��isTKf� S7RUC� U2 �q-. Gil CityI-�J�Rr-57- State F` -7l". Zipj1 Telephone Qp329/0/f/ (( / CONTRACTOR'S NAME/COMPANY uL R � �fYC�''�Q14 Lic.<N7o. lr-j-Class F Contractor's Address Contractor's E-mail Address 30/S' 172 5 SO GROW AXEGK� �MeKCO, t y city I OIyTL:RIOM1 State Zipq(7�6l TelephoneRN- q4-7 q467 SETBACKS REAR SETBACKS FRONT PERMIT NO. PLAN CHECK NO. SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PLAN CHECK FEES $