HomeMy WebLinkAboutX2015-1521 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application ozEW�Rm
Comm'I j Residential City of Newport Beach - Building Division Y Z,615, - 15.
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 5.;�oa•"
Building r Grading F"Drainage F_Elec (`Mech f— Plum Cu Yd cut Cu Yd Fill
Project Address g(Not mailing address) C Flood [_ Fire (- Liq I-" Landslide FN/A Floor Suite No
Description
AofWork { n Use �ti I Const Type --
A414 # Stories
#Units if Res)
y_t Yvon 57t�2.
Valuation $
New/Add SFJ Remodel SF[—il Garage/New/Add f Material/Labor
OWNER'S NAME Last First
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Owner's Address Owner's E-mail Address
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city W e,` J �c Q §r Sri — -- State C'.($ I Z
Zip- -7& C> I Telephone C �?
_ --
APPLICANT'S NAME(I q
Last First�'L.----------- �----'----�—'—��--------
Applicant's Address
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City�State
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ARCHITECT/DESIGNER'S NAME Last `
Architect/Designer's Address
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Ar
y vr
k_ vtvNe State C
Cit ...--- ---
ENGINEER'S NAME Last
Engineer's Address
City rs--_-- I State �vl
CONTRACTOR'S NAMEXOMPANY
Applicant's E-mail Address
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Zi Tele hone
._. First �osep........_I Lic. No.
Architect/Designer's E-mail Address
Zip Tele hone l
First I Lic No.s
Engineer's E-mail Address
Zip ��� Telephoned
Lic. No. F-- ---J Class
Contractor's Address Contractor's E-mail Address
city State F-7 Zip F.- Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. m
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $