HomeMy WebLinkAboutX2018-1943 - Permit ApplicationX20tg- ta►H3
' Print.Form _!0 Worksheet for Combo Building & Solar Permit Application d W �"a
[7]Comm'I L7 Residential
City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G.,,,.+�'
❑Building ❑Grading ❑Drainage ❑Elec ❑Mech F] Plum cu ydcut
F77 CuVdFill F]
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
'2500 13A'(Pb1,Q-r6 'D12 , NaJRXT BeAck i M 9Z6( 0 F_� 0
of Work
New/Add SFC� RemodelSFF77---71 Garage/New/Add
OWNER'S NAME Last Ifrim m-A1r`t/ 1 First
Use 171 Const Type
# Stories❑ # Units (if Res)❑
Owner's Address Owner's E-mail Address
I31 "fFtt�r2y'I m 01e - 11,o fVflle m rpt .Cant
City I ,^12V I I^(6 State ® Zip I-� Telephone 70
APPLICANT'S NAME Last
Applicant's Address
24,50 WET lava. soli!✓ D
City 1LU31>!�� State
First I -nil A -r7
60
Applicant's E-mail Address
blaw kd�c�mtc4;aMl'n . car-,
Zip � Telephone 8Q j-2,1544
ARCHITECT/DESIGNER'S NAME Last First E77-71 Lic. No.
Architect/Designees Address
City State
ENGINEER'S NAME Last
Engineer's Address
City State �—
Architect/Designees E-mail Address
Zip � Telephoned
First Lic. No. 70
Engineer's E-mail Address
Zip [� Telephoned
CONTRACTOR'S NAME/COMPANY Dc �G' Lic. No.T(,1 _�077class
Contractor's Address
I� �A gi,
Cityc[x�(Af�Ic_ I State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail LAd�drre�s_s
A� +On 0, ac,(,� Ct4ell a InC C. C Orn
Zip I 2530 I Telephone 1}�
PERMIT NO. x / t )190% —
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $