HomeMy WebLinkAboutX2017-1924 - Permit Application (2)20 l
o eet for Combo Building & Solar Permit Applicatiol�2�
City of Newport Beach - Building Division a
Comm,[ esidential �A J ITC DI An rucrtc FFFc nl IF ATTIMF OF SUBMITTAL
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Project Address (Nott m' ailing address) C Flood f— Fire F- Liq Landslide A Floor Suite No
Description of Work
se Const Type F
# Stories — # Units (if Res)
Valuation 5 17- 00
Material/Labor f
New/Add SF— Remodel SF �— Garage/New/Add
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OWNER'S NAME Last
�� First
Address
Owner's A
Owner's E -ail Address f
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City �,j 15
State 1 `-d-+- Zip F— Telephone ,-Tj 1,/ 2�
APPLICANT'S NAME Last
C L L( 1-0 - First
Applicant's Address
Applicants E-mail Address
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City c�fz-- 'r'j1vLr�.'f- State �V"' Zip _ (2% V_ Telephone �`f / �6 0 �' 0 C7
ARCHITECT/DESIGNER'S NAME
Last I First Lic. No. �—
Architect/Designees Address
Architect(Designer's E-mail Address
City
State �— Zip �— Telephoned
ENGINEER'S NAME Last �Pf C�(� First Lic. No. 6�
Engineer's Address
Engineer's E-mail Address
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City
e State i ZipI !Z. Telephone `7/j 630 1CjZ�
Lic. No. �YLBZ Class C�
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CONTRACTOR'S NAME/COMPANY
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Contractor's Address
Contractor's E-mail Address
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City !V I � h
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State + Q Zip j / 26`'l l Telephonell G.5 JI Z?� y'V
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SETBACKS REAR
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SETBACKS FRONT ERMIT NO.�� L-1
SETBACKS LEFT
SETBACKS RIGHT + PLAN CHECK NO.
r v FEES $
USE ZONE''
NO PLANCHECK