HomeMy WebLinkAboutX2017-2052 - Permit Application (2)Oil
Work eet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
F7 Comm'I residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
. F- Grading F -Drainage F_ Elec
Project Address
2-41 S
of Work
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Floor Suite No
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New/Add
OWNER'S NAME
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Last So. ) _ First[ ALD
Use F_ Const Type
# Stories # Units (if Res)
✓aluation $
Material/Labor
Owner's Address Owner's E-mail Address
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City Q4:µ PpO 771AS- State Zip Telephone 7(,335 rS�D
APPLICANT'S NAME Last �� First 0 2v��
Applicants Address Applicants E-mail Address
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city
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ARCHITECT/DESIGNER'S NAME Last ';'%&, y, t �-- Lic No.
Architect/Designer's Address Architect(Designer's E-mail Address
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ENGINEER'S NAME Last 5 VA"6�L: First 11 C fi-g1 [� Lic. No.
Engineer's Address
i 2.01tA
City I aNAti4.)+v.. State
CONTRACTOR'S NAME/COMPANY
Contractor's Address
Engineer's E-mail Address
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Zip--� Telephon-ilt�-7-79 .-6�40
Lic. No. Class
Contractor's E-mail Address
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City State _ Zip Telephone] _
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
I USEZONE DEVELOPMENT NO
PLAN CHECK FEES.