HomeMy WebLinkAboutX2015-2984 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Appl%tii
_ City of Newport Beach -Building Division
Comm'I Residential°
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F -Drainage F- Elec
Project Address
Liui i Rwerc% Terrcace
of Work
F_ Mech F Plum CuvdCut I -
F_ Flood I- Fire )- Liq I- Landslide
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Garage/New/Add
New/Add SFr v Remodel
Cu Yd Fill 1 -
KN/A Floor Suite No
Use SSD Const Type
# Stories[T # Units (if Res)
Valuation $
Material/Labor
OWNER'S NAME Last W.1Garn5 Firstl c�}e�n + Monrkq
Owner's Address Owner's E-mail Address
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City Na�,s�or� Bch State �— Zip `12Co25 Telephone �{9-(Ai5.5`�
APPLICANT'S NAME Last V5-ra
First FN,., In
Applicant's Address Applicant's E-mail Address —__ _...
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City Ne�.+C'or� �eac`n
State FcW Zip x\21. to 3 Telephone y`1- Gq4 D' 58 o4
ARCHITECT/DESIGNER'S NAME Last First iyrtan Lic. No. C$ 012
Architect/Designer's Address Architect/Designers E-mail Address
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o ch State Zip 1 `�.-L.r Telephone q -(oiS SFSS�
City j�1ew(�orF �•
ENGINEER'S NAME Last l M�.as4�Adt
First Forma ci
Lic.
Engineer's E-mail Address
'ineer's Address
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State I GR Zip �t'�--1 DI Telephone "I1`F- $ 35-2 $Oo
")R'S NAME/COMPANY �y�j 1kUr �/� Yet i Lic No. U(f��2 Class(
'ress Contractor's E-mail Address
kf_4N, State - Zip � l �+ Telephone d -I �+Ti 4�'%%/�'(%V
SETBACKS FRONT PERMIT NO.
SETBACKS RIGHT PLAN CHECK NO.-'-E_-�
DEVELOPMENT NO PLAN CHECK FEES $
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