HomeMy WebLinkAboutX2015-3098 - Permit Application (4)Print Form Worksheet for Combo Building & So@ar Permit Apphcation
Comm'] J ResicTen`fi� S - -30019 City of Newporteach -Building Division 3LM V)'q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL A i&if )
"uilding r Lading f—Drainage ep�_Elec Pc Mach Plum Cu Yd Cud
PrroDect Address (Not mailliling address) F_ Flood Ye Fire r- Liq F_ Landslide
JLI 5 0 V 10. Onn✓� o
of Work
New/Add SFI [-I gop
Cu Yd Fill
FN/AFloor
Suite No
Use A ConstTypejjf
# Stories # Units (if Res)I
Valuation $
Remodel SF1_ Garage/New/Add r Material/Labor
OWNER'S NAME Last
FirstLlA. �rv�,P��i-q r' L -`-C
Owner's Address
I
` Owner's E-mail Address
I3�oc� N2.w�✓A levo Suite )Oct v''01✓ tZen(C �JY✓ c��l�c .Covey
cit ` State
n
Y �Je�. or--, 't�ec.c,''� .Telephone
P C Zip �26(�
APPLICANT'S NAME Last I l v�eZ
Applicant's Address
17E,y4� qe Pl,Vk I E7(,rle (�
City I `('v t,�_ State �A
ARCHITECT/DESIGNER'S NAME Last
�qr
Architect/Designer's Address
(-1�5LI i< P"'I- c4vJO )�& 1+�g
City State
ENGINEER'S NAME Last I C--*- („yAI
Engineer's Address
2q b
City irV1�E State CA
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City ..
SETBACKS REAR
SETBACKS LEFT
USE ZONE
First l 3..y
Applicant's E-mail Address
Zip °f fly Telephone WFI Ry7 757-924D
First 0S_41 " I _ Lic. No. G -2`i `l -11
Architect/Designer's E-mail Address
Jo,$e k 0 -�->wl S- ctvc . a o w}
Zip I Telephone 1 �1. -) 51. 3-,t{ a
First I'S 8AM Ie 1 Lic.No.) LA -1??)
Engineer's E-mail Address
GRiMM@UStf- 'Vct+«AL.(Y
Zip 12IQ i Telephone qL�Q _2_
�l50
State F_ Zip
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
Lic No. Class
Contractor's E-mail Address
Telephones_
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $