HomeMy WebLinkAboutX2016-2747 - Permit Application)�,ZCJI& -`L71-4%
1_ _ Print Form j Worksheet for Combo Building & Solar Permit Application
F_ Comm'1 `Residential City of Newport Beach - Building Division
/ NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building r' Grading F -Drainage F-Elec r Mech r Plum Cu yd cuts— Cu Yd Fill F
Project Address (Not mailing address) r Flood r Fire r Liq r- Landslide -_N/A Floor Suite No
O s 1�A FRONT, Nei eac� CA U9902(a� � F_
Description of Work
Use F Const Type s_
131 Li%1eeiR
OF GI'LU
cc�91(
# Stories # Units (if Res)F—
Valuation $
Material/La
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New/Add SFF— Remodel SFF—Garage/New/Add I J
OWNER'S NAME Last D
First ARQY 4. T -RPCY
Owner's Address
Owner's E-mail Address
53o1 ?5,y ���
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city A�OI'NoR-\{\ h State cN
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Zip I GLI&W Telephone qq.
APPLICANT'S NAME Last �1Z N lJ
First I ChRlsi
Applicant's Address
Applicant's E-mail Address
;001 'M ft -1- -AVE -"4 I-WIL
City cosA 1 iesA State CA
[C,'�hpRIS/�3RIvvO�t�I�QGth7EC[l/S.uCOVr�(
Zip �(2t'Zry Telephone Iy''75l JY0
ARCHITECT/DESIGNER'S NAME 3I63�
Last ANON First ChR)5 Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
3061
City C 11 A State I CA
Zip Telephone
ENGINEER'S NAME Last
First FApy Lic. No. C-- f 61-34
Engineer's Address
Engineer's E-mail Address
4(0 C-)pDDARD Svl 2co
FAD114AKIYtPFYI HUNCalwZT-RINGr•Carl
City 1RvINE State FCk
Zip I a-j�Ia Telephone gyol 2yS 8000
CONTRACTOR'S NAME/COMPANY �r{ j �6N C� _
�pVeW V81TC1 qoN Lic. No. [_ Class
Contractor's Address
Contractor's E-mail Address
1S C09 -yo J�'a� Su 1So
I ' �"
h0ve'`)1@p NCUq 6H IloKes.cov-+
city I ""' w`Q� ��� State CA
Zip "I GV6O Telephone �1U ` �23 150c)
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $