HomeMy WebLinkAboutX2017-3087 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F-- Comm'I IR Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F -Building F' Grading F -Drainage F_Elec F-Mech
F_ Plum cuvdcut F Cu Yd Fill F_
Project Address Not mailingaddress F Flood
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F- Fire F-' Liq F7, Landslide [N/A FI�, Suite No
7, � 11 o�Anl xw 1p
_ 77
Description of Work
Use F_ Const Type F
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#Stories!, #Units (if Res)F—',
Valuation $
New/Add SFF _0 Remodel SF1_i;_ Garage/New/Add Fo—
Material/Labor Floo,mo -
OWNER'S NAME Last bl os
First �FO )
Owner's Address
Owner's E-mail Address
11,3111 oce*N 6tuD.
City (.OtLiiMt__��.-.�`(..�, State-'
J,
ZipA -/'V[jTS',Telephoner
APPLICANT'S NAME LastI K
First �T
Applicant's Address
!!�
Applicant's E-mail Address
14.5_ W 141*0 S 14W . _0 200
City I Tv"TIN... _ State r _C_A� Zip
q2 -.._. Telephone(—
ARCHITECT/DESIGNER'S NAME Last (,tµ(
First Lic.No. 'fi7i�j3ff
Architect/Designers Address
' ect/Designer's E-mail Add
City State F-�--. Zip F Telephoner
ENGINEER'S NAME Last(� jf C �_
FirstV Lic. No.F
- - 4-7010
Engineer's Address
Engineer's E-mail Address
City State F _ _ Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY MS i C_ V- C� t p Lic. No. 7 (� 7 4 Class F
_C
Contractor's Address
Contractor's E-mail Address
L�fS_ t r, MM j 5-r-S'C11T� 2_0o
fo�I�w' @-81hi- conSf fuc�ron ,Com.
City _`�S'fl t� ------ -___ - State - Zip
cl'.Z-� Telephone % tC{ _ 4 93 -.-27 Sb.._ _
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $