HomeMy WebLinkAboutX2018-2687 - Permit ApplicationOwls- 2(p8i-
__Print For -"Worksheet for Combo Building & Solar Permit Application ®r%04,`V,
" City of Newport Beach - Building Division
-;C;msm ResidentialNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL 0
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Description of Work
UseL fIJ�� Const Type n
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Pool- A(LCA
# Stories #Units (if Res)
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New/Add SFF___7 Remodel SFF---7
Garage/New/Add F___71
Valuation $
Material/Labor Fb
OWNER'S NAME Last 7 ut [2Vt�LJB Gon+FAVY First
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last I-0mELT
First
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last —
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State C�
Zip Telephone)
ENGINEER'S NAME Last AC p E27Sorr/
FirstRLQ6Lp/t� _ Lic. No.IoSS �3
Engineer's Address
Engineer's E-mail Address
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City - /1J, ,3 - _ _ _ State C,Q.
Zip b/ 2GL o Telephone �j '7°lj 3s'/ - -s'.3 Z _s -
CONTRACTOR'S NAME/COMPANY Lic. No. C Class 1
Contractor's Address
Contractor's E-mail Address
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Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
y:ETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $