HomeMy WebLinkAboutX2017-2954 - Permit Applicationt Worksheet for Combo Building & Solar Permit Application
Comm'[ [IIIEsidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[Building [Grading [Drainage ❑Flet [Meth [PlumCuvdCutF CuvdFill
Project Address (Not mailing address)' C Flood ' [ Fire [ Liq [ Landslide [N/A Floor Suite No
3,.> --
Description of Work Use Const Type n
# Stories #Units (if Res)
(� MateValuation$ ' (Vt�
4}
New/Add SF , S. Remodel SF L Garage/New/Add I rial/Labor f
OWNER'S NAME Last first;
Owner's Address Owner's -mail Address'
3 i�A�$ovQ IAo\NT i 20
CityN&�- �r rta/�� 'State Zip gZdZ Telephone 3fp�xi� J
APPLICANT.'SNAME Last �.� First
Applicant's Address -- - Applicant's`:"E-mail Address
City State Zip G(��ZcL) Telephone '(t4Lot�p tspG
ARCHITECT/DESIGNER'S.NAME Last, First w(t t, Lic.No.
ArchitecUDesigner's Address Architect(Designer's E-mail Address
323t X)�t o cx
City State ��h Zip C�Z�^�� Telephone a��a�6�40
ENGINEER'S NAME LastFirst
iNL' � I Lic: No.
Engineers Address Engineer's E-mail Address
i
City �- State Zip,� r lephone�1
CONTRACTOR'S NAME/COMPANY h1LLG Lic.No. {63112 ClassI`'
Contractor's' Address ; - Contractor's E-mail Address
P32 l /4-Y21 7WM(tt r)eveCX". 6bt-4,
City ' ✓,T �!T 'Ffjln/j' State F_ Zip' C� Te'li h6ne'(I4{ Ot76 J
SETBACKS REAR SETBACKS FRONT PERMIT NO. beZo y
SETBACKS LEFT SETBACKS RIGHT L�1 ! PLAN CHECK NO.
USE ZONE DEVELOPMENT NO �%2D % -Q S PLAN CHECK FEES $ Z