HomeMy WebLinkAboutX2016-3427 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application EWPo�
F_ Comm'[ Residential City of Newport Beach - Building Division ytobv
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �uFoa„•
F --Building F_Grading F"Drainage F_Elec F_Meth F-PlumCuvdCut cuvdFill
F
Project Address (Not mailing address) F Flood C- Fire r— Liq F- Landslide rN/A Floor Suite No
Description of Work ���, �. ���•
Use I -Const Type l
i# Stones - # Units (if Res)'
New/Add SFF— F Valuation $
Remodel SF{— Garage/New/Add Material/Labor��'� _-
OWNER'S NAME Last First
`N o�l'�
Owner's Address `. Owner's E-mail Address
City �— __ State r—__ `.
-- -- l Zip �_._.— Telephone `”` i cl —
APPLICANT'S NAME Last First! r-�
Applicant's Address Applicant's E-mail Address
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City I 9,)y\,T6�,.i tY \�__ State r(liti- - ` -_ -
-_ v Zip q _:q (-t Tel /� � `�J --I <'i Cq D
\ARCHITECT/DESIGNER'S NAME Last
First _ Lic No.
c itectlDesigner'sAddress Architect/Designer's E-mail Address
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City State ZiP�—. Telephone�/�4-5`�'9-g',3J�`a
ENGINEER'S NAME Last — (Lic.No.
-- —_� I X}2S First 1I\C�f1C[S CC7J�CiL1�
Engineer's Address Engineer's E-mail Address
CLQ I_ - W _140' sfi- ty
City 1 l (0.C�fnGt State Cp( zip Telephone 66
CONTRACTOR'S NAME/COMPANY---
Lic. No. f Class—
Contractor's Address Contractor's E-mail Address
City �— State �— zip — Telephone(--
SETBACKS REAR SETBACKS. FRONT PERMIT NO. - x`jv I (s. 4-1_1 -
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $