HomeMy WebLinkAboutX2016-1101 - Permit ApplicationPnnc'1 Qrm" '` W heet for Combo Building & Solar Permit Application
❑ Comm'I 5? ResidentialCity of Newport Beach - Building Division cul iD I D
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
,Building Gradingj rainage �Elec aWech Plum Cu rdcutl l Cu Yd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑I Liq ❑ Landslide ❑N/A Floor Suite No
4&o-7 CAMDEN 1-�R . NF—t 1pc>PT I; N 0
Description of Work 'iNlumUse F7ConstType 1-71
CoNSTRiScT A 7W0 5'1'oRY HoME
CSe.1$ VIZI?ANPA�I,� W �f�R<LC-t��I�E� & POO,L #Stories #units (if Res)❑
Valuation $
New/Add SF �� Remodel SF 1:77--7 Garage/New/Add I y Xo!'► Material/Labor
OWNER'S NAME Last I G .R o f y ! First
Owners Address Owners E-mail Address /I/�C „/S%�•�
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City I NNPORT RZACH State C -A . Zip q2 tits . Telephone gScq 2
APPLICANT'S NAME Last
Applicant's Address
loo 13ALeoA ,AVe _
City L id A (?V�CI—I State
First -fu P/1%,I
Applicant's E-mail Address
IN Fp @ M,�I�KS�n]lsr.ER<i2CHf T�Q'S, ao
Zip Telephone j , ,6 V9
ARCHITECT/DESIGNER'S NAME Last �Q'-\ JI First y PN C' Lic.No.�
Architect/Designer's Address
oo BAL-BoA Avg _
city FT- 14AA RR:ACH State[c—A-
7,1
ENGINEER'S NAME Last
Engineers Address
I
JI
City FAC H State
Architect/Designers E-mail Address
I/y;:O dR AAARKS7 4 CrEk t>, cHffec re
Zip `6� I Telephone 99.W y
First NEN �Lic.No.
Engineers E-mail Address
Zip Telephone
CONTRACTOR'S NAME/COMPANY D M Lic. No. Class
Contractor's Address
2-� i✓��,4�-e1' S i S���� �Oc7 �I
City �g w State
SETBACKS REAR„ I SETBACKS FRONT
SETBACKS DEFT/-qj-N ( SETBACKS RIGHT
USE ZONE V U/ DEVELOPMENT NO
Contractor's E-mail Address
63
ZipZJ Telephone
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $