HomeMy WebLinkAboutX2017-0944 - Permit Applicationj 001-201 - x2o(�--oYYy -
I Worksheet for Combo Building & Solar Permit Application
7 Comm'I (X', Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r,BuiIdin9 FK-, Grading Drainage FXZElec [)-�Mech rPIum Cu rd cut i2 CuvdFill F —400
Project Address (Not mailing addr
CO2 �oln5r,G��a
)escription of Work
t1Pw a -Story a, n, I< -k
(- Flood r Fire Liq F- Landslide
New/Add SF IU9I+I?-_P Remodel SF Garage/New/Add412
2
1 04 > of
OWNER'S NAME Last ,._fj �,(I��r j„c-t-n.,.. U,rw,e5 First
Floor Suite No
Use R 3/5,, Const Type FA _51
# Stories # Units (if Rest
Valuation $
Material/Labor &0a/
OwnersAddress CoAgcWi-f :: N�, GWtGI Wr"(kGi Owner's E-mail Address
City F_— _� State Zip ( Telephone Rwq -Zgo- -7c,33
APPLICANT'S NAME Last
Applicant's Address
2°l00 1'Jrisinl 5t- 3id4A. S -t Je, 2o3
City ��-�� State c;A
ARCHITECT/DESIGNER'S NAME Last
First
Architect/Designees Address I x�t"I'tG w, 0,16N Architect/Designer's E-mail Address
t
City � _. State F-7-7 Zip I TelephoneF_
ENGINEER'S NAME Last � ( I.M First ..1�; Lic. No. 6-15 %.3 co
Engineer's Address
City j V', A e State Cid
Engineer's E-mail Address
Zip___�ZI 1pV Telephone '3toLi.7- . 15310
CONTRACTOR'S NAME/COMPANY � j . � Lic. No. &S, a r) Class
Contractor's Address
1+1 1/2 arcn tc Q _ . -
city M _. '. state Fc-
SETBACKS
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
c �kosc�cs wlno� tis [-V_, Mati.co
Zip )-Gi-S..... TelephoneF(vo'."2.}O-76 3-S
`eP2�)
PERMIT NO. A '/ g 11 I
PLAN CHECK NO.
PLAN CHECK FEES $