HomeMy WebLinkAboutX2018-2988 - Permit ApplicationPrint', Form .Worksheet for CO
mbo Building & Solar Permit A
F Comm'l FResidential City of Newport Beach - Building Division )�hllCation @d'i
E— aNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -Building f` Grading F`Drainage VElec W.0
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Project Address (Not mailing address l_ Flood N Yd Fill l
2 ) (� Fire (" Liq � Landslide I`N/A 'Floor
Suite No
CIA 97-6L3
Description Of Work J
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Use Const Type
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io ��T81 g mNts N
U T�Tmea� i'y s TAA vs. #Stories-,
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ReSF Gara a/New/Add Valuation 5
Material/Lab C.1
OWNER'S NAME
Last '�ttEop
Owners Address O _ First F,4< �x C, Ll
Owner's
53-z- PatC✓O Owner's E-mail Address
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city Pod,oS �c ('----- A QP®CMA4IG<co0-1
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APPLICANT'S NAME �7������'�'�" �3f a C� 12 �80�5
LastI
Applicant's. Address First 17jCI�`
57*? FAS; 0 Applicant's .E-mail Address
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7_74ARCHITECT/DESIGNERS NAME TelephoneF(?�!®�
Last?v.
ArchitecUDesigner's Address First
Lic.No.��
Architect/Designers E-mail Address
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it
State Zip �} �� ?�Y91,
C°!.2_J p Telephone ?g, , 3 _0r
ENGINEER'S NAME
Last �
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Engineer'Address First Lic. N
Engineers Adtlr - - o.
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Engineer's mail Address
city State
v� a
Zip
7c�`�� � Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address Lic. No.� Class
Contractor's E-mail Address
City
I
State. F�� Zip. Telephone[�--
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SETBACKS REAR - i
SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT PERMIT NO.
PLAN CHECK NO.
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