HomeMy WebLinkAboutX2018-1943 - Permit Application (2)X20%%- toig3
PrinrForrn Worksheet for Combo Building & Solar Permit Application
❑ Comm'I ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[]Building r7 Grading ❑Drainage ❑Elec ❑Meth r7 Plum CuvdCut E77 cuvdFill F71
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
ZSi7o �ifEY�o�,-1`E DP_ , N6iJrP0Z7_ 8 8A014 t e1A °12660 7 0
Description of Work Use F7 Const Type
L& 6 --yr- 6-� (S # Stories # Units (if Res)❑
44)
New/Add SF[ ------J Valuation$�ga/New/Add 8�obo
Material/Labor
OWNER'S NAME Last ! t�' eP�v7V� First' L I✓U Pic
Owner's Address Owner's E-mail Address
131 'T tC�r2y' m peA le5,•,',o It dine cam fj Can
City 12V 114 6 State ® Zip i �- Telephone tD "�o1og 2�
APPLICANT'S NAME Last I i Aqr ) I First I -Cw, , A,.. �
Applicant's Address
'��v0 Wt�tavuT J$/�. iTar
City j t13 � State
Applicant's E-mail Address
blctuir�,
Zip�,'Q Telephone �jQ 7-•L� %�'L
ARCHITECT/DESIGNER'S NAME Last First F77-71 Lic. No.
Architect/Designer's Address
City State
ENGINEER'S NAME Last
Engineer's Address
City State
Architect/Designees E-mail Address
Zip Telephoned
First �v Lic. No. 7 0
Engineer's E-mail Address
Zip Telephoned
CONTRACTOR'S NAME/COMPANY I �C, ( (A �\_ i Lic. No. �b�2o� Class
Contractor's Address
City bi/e EZS 1IJnz c, I State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail LAddress
ins CArn
ZIP TelephoneN�
PERMIT NO. tx"r!� �, — ICI
PLAN CHECK NO. `C� I x O
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $