HomeMy WebLinkAboutX2017-3695 - Permit ApplicationPrint Form W rksr et for Combo Building & Solar Permit Application e i pR,a
r Comm'l (- Residential � City of Newport Beach -Building Division ,26s0•i?O17 � ,. `;
WW NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X261-7-361?5 �^<,�oa�••
ry8uilding F_ Grading ainage rElec rMech F- Plum cuvdCut F CuvdFill ro
Project Address (Not mailing address) F_ Flood r Fire rLiq r Landslide F_N/A Floor Suite No
5'-�5 mwa�� , LoYonO. de\ Mo.r I F -
Description of Work
Use SPc' Const TypeV P�
# Stories'., # Units (if Res)
'`Arrow bn'2vioc t¢�no�e\ ak tH} .
Valuation $ 'New/Add
SFF0 Remodel SFapp Garage/New/Add�Material/Labo1�0
OWNER'S NAME Last SuSson
First .p Ma'cli�q
Owner's Address
E-mail AddressI i
�
S95 SGa1WQr�1 P-ood
FOwwner's
-
I ih�o@ �9- tY�G .IGpm�
City Go'ccna del Max..... State
Zip `j2G25 Telephone 949-(0`45�SB-a 4
APPLICANT'S NAME Last E�1(�pX. _
First I Y_R_14y.. ..
Applicant's Address
Applicant's E-mail Address
y-10 o\do\dNe,,,Q,r-\- Pa\��• _.
�-11y�@�,jq-irc. com
City I `"a"-'t'°v'1-ac�. State �
Zip . �2(oto '�j _ Telephone �1`�`l-
ARCHITECT/DESIGNER'S NAME Last segnn¢'F�C.. _ First i;Z-sn Lic. No. C$01'Z.
Architect/Designer's Address
Architect/Designer's E-mail Address
4710 O\d New 6hi2�.
City New�brF Q�egc\n State GP.
Zip 92,(0(03 Telephone ,L-�-(ak$-5,r.
ENGINEER'S NAME Last I \/ kTe
First i;�1cer"� Lic. No. COaSll6
Engineer's Address
Engineer's E-mail Address
F20321 iaKe Forest �XN je
I , Ssfce �- 6
\pob @ 'cw+volee. Gerr
City hKe F�es•Ic StateZip 4
Z
i'2-(e3p Telephone 0{�9'305-`x.100.
CONTRACTOR'S NAME/COMPANY Tp;��\ i Lic No. Class
—+ • �^2 s
Contractor's Address
Contractor's E-mail Address
City �n `�p_",� �,.p( State C�
S�f�c
Zip g0�(p(p Telephone 7fq-••1'��-
SETBACKS REAR SETBACKS FRONT
PERMIT NO. -4v rl • .�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. .(� b •l�
SE Z E DEVELOPMENT NO
PLAN CHECK FEES $