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HomeMy WebLinkAboutX2017-2568 - Permit Application1%W -R Worksheet for Combo Building & Solar Permit Application City of Newport Beach- Building Division X Lo j �- 15 r F_ Comm'[ Residential fL n KI nucrw PGFR nl IF AT TIME OF SUBMITTAL ilding Grading f -Drainage F_Elec FMech Plum cuvdcutF— cu Yd FilljUgr Project Address (Not mailing address) f- Flood 1 ire F_ Liq F Landslide FN/A Floor Suite No \ (� ° F b21 tb (0 V C�Esw� V. � (-•) ,J, �i Description of Work Use I dconnsy§� ypee IF # Stories, #tUnitts (if Res)i Valuation $ P,.© �— Gara a/New/Add I ►�.� Material/Labor) d �� New/AddSF� h.l �. Remodel SF! 0:1 / F+I- 9 -j/�- 7 -- OWNER'S OWNER'S NAME Lastl y-.�'y�� CC_ 0,,•�'y'rst1 Owner's Address Owners E-mail Address CityJ Nem p.� k e�c.J� State C' y� Zip my b v Telephoner------- APPLICANT'S NAME Last V- +,��, First - J e�Ov� Applicant's Address CApplicant's E-mail Address 1 S�'c '�21�� Cc1v`��ccto f _-- — Ci tYi s State Zip Telephoned ARCHITECT/DESIGNER'S NAME LastI�`�e%�"T ';Te- j:> C%e. — Lic.No.�- Architect/Designees Address 1 V Architect/Designer's E-mail Address City State I Zip Telephone _ r— rJ ENGINEER'S NAME Last CX S- ' a irst Lic No? wi �c) Engineer's Address Engineer's E-mail Address _So (`t oVi City State 1 if Zip! fi.1 p 3 b Telephone) y �Q - 1 CONTRACTOR'S NAME/COMPANY Lic No. q Qj 0\�\2 Classi Contractors Address aContractor's E-mail Address �y1��� Via Jati. JN0-v,/*P JaSc� ,A 0, j city\--� \ State! Zip, q 3 6 j Telephone) 1 L�q SETBACKS REAR SETBACKS FRONT _ PERMIT NO. iCLI.75b� SETBACKS LEFT PLAN CHECK NO. SETBACKS RIGHT nm,,=r noft=NiT Kin PLAN CHECK FEES $ 'i