HomeMy WebLinkAboutX2018-3166 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Applicati ,E_P�.
�; comm" Residential City of Newport Beach - Building Division �� {�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `�`"�"�
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Project Ad ress (Not mailing address) F-1 Flood rJ Fire [- Liq _-sLandslide nN/A Floor Suite No
Description of Work
Use R 3(D Const Type V�
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# Stories[- #Units (if Res)
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valuation 5
Material/Labor
New/Add SF rTg0 1 Remodel SF `�` 0Garage/New/Add 1
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OWNER'S NAME Last ��j r First jeVj
Owner's Address Owner's E-mail Address
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City N (�d2i i�Lfi< } State t ""� I Zip L_, T-J p Y� --
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APPLICANT'S NAME Last First j
_ Applicant's Address Applicant's E-mail Address
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Cityrj,cF� CL.`>^-�L7U�- - _ - State Zip `72G 7Z Telephonel¢f 3fS OroCJ
ARCHITECT/DESIGNER'S NAME , �� Y�
Last �/kvVr First Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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I City State Zip J Telephone --
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address Engineer's E-mail Address
City ! - . J State �� Zip J Telephoned
CONTRACTOR'S NAME/COMPANY ILL-T-E 8LA-c-1,_ Lic. No. gP9231631 ClassF7
Contractor's Address Contractor's E-mail Address
City (1gState Zip i Z�Z,7 j Telephone 714)G_[Z-747&1!
SETBACKS REAR SETBACKS FRONT PERMIT NO. N 2,0, & 3if Lp
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2-410 V 2_eI 16
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $