HomeMy WebLinkAboutX2017-0896 - Permit ApplicationPrrt Fo rn zi WorT� et for combo Building & Solar Permit Application °Ra
F Comm'l Residential City of Newport Beach - Building Division
NOTE:
PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading [''Drainage �lec Amech lum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) I- Flood Fire Liq r". Landslide ' _(<A
Floor Suite No
190® Uedl Drives
Description
++of'Work Use 4?S_0ConstType yg $
30
!Aed
ua
It Stories # Units (if Res)
Valuation $ n�y Q
New/Add SFr T36 Remodel SF �~ Garage/New/Add l Material/Labor (2 D t q l11
OWNER'S NAME Last l GIOXIO -d0 Firstl A A 1 ahU
r
Owner's Address Owner's E-mail Address
City I NeijruirL �c,,GH.. State if/h..... Zip 'Z 7_5 Telephone
APPLICANT'S NAM!�� Last ( M( (moo d i ev
Applicant's Address
City I &4,r6NZL, 07,W cState 'CA
First ( Ir 1'
Applicant's E-mail Address
Zip. Telephone)9__Zet-5.-2,I7&
/DESIGNER'S NAME ��y� L
Last I ( \�e' oclie'V FlrstTV, Lic. No. r
Architect/Designer's Address
ri�
City FQQ Zp 1;t L;� State
ENGINEER'S NAME Last ICS" k ,
Engineer's Address
City L��JE� �1J,,\ State C: �...
Architect/Designer's E-mail Address
er ViJ j VCAV-10 iZ--,, COM
Zip 1Z.jo&o Telephone... 11.1-Zz� r . 1 2.—Z'1 t W
First�V A Lic. No.3- _4764
Engineer's E-mail Address
AJ !% (S CCa^-1
Zip Flo—e" TelephoneF'fc z--� 3�'� BC.�
CONTRACTOR'S NAME/COMPANY , G (E AC11\4I Co�`NLA-cTo Fl Lic. No. rc��(��8 ? 2Class
Contractor's Address Contractor's E-mail Address
c.sv BAKer Sl �`ts; vreraSc�� V-1 C_C�•�
City r ,r r:"t e j el- State �` Zip I Z� Z 6. Telephone 7/ tf �c� CJ �_ 3t/..s
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT �j PLAN CHECK NO.
DEVELOPMENT NO '��/ l PLAN CHECK4-€ES $
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