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HomeMy WebLinkAboutX2017-0338 - Permit ApplicationPrint Form _ I Worksheet for Combo Building $ golar Perrhit AanUcatlon"A A-.-Qx 7 o r Coiriin'I °Residential 2015-OL4q City of Newport Beach -Building Division C_Ep L01,30 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building Grading Drainage �Elec ><V1ech xPlum cuYdCut �p\cj cuydFill F Project Address (Not mailing address)) I- Flood r- Fire I V Liq r Landslide r_N/A Floor Suite No \215-DolFhir�Tantace ©�q5 20 �7-' Description of Work Use 'Spp Const Type Vb New \-�*""'') C3`vs basem�� yng\e �ares\1y �ces\�er�ce w� atEache� # Storiesr2 # Units (if Res)F \-car �- car �ara�e and �ra�e . Valuation $ Material/Labor \IL�0O1ppp New/Add SF 7,kb& Remodel SF�— Garage/New/Add -!S'j c N w clncA�ccl\ OWNER'S NAME Last \'_)t,jer \vY(rte, U..0 First _ Owner's Address Owner's E-mail Address a`\o\ \N. Goash- *-;' oa \moo \rc . c orNI City New r} QJea c\rl._ _... State G{i .. _... Zip `17 (ot.�j Telephone yq-t,,{g-S4S`P APPLICANT'S NAME Last ?xtr� !', First M1 Applicant's Address Applicant's E-mail Address 'C-1 O O\dt k\e,�Nr • '�\V� •. ChFC �% ��i' \Y`G . LO`M City �\ork Q�e�.c\n State �— Zi �V Tele hone��j P �12�n V 3 P 9'`'4`I - /o`\ S -S85 ARCHITECT/DESIGNER'S NAME Last 'Seotvvnehe First pjrtan Lic. No. GBo\1 Architect/Designer's Address Architect/Designer's E-mail Address wA O o\ci �\ew�Cn t \v� . ` City State4jN1 Zip Telephone �\9- (Acb- SeSA e ENGINEER'S NAME Last First Fady Lic. No. G^iS-13ta Engineer's Address Engineer's E-mail Address 11 \rv\re State —Zip �S5 Telephone L� �\2b\ p `l`t9^`421-\5�j6 TRACTOR'S NAME/COMPANY Lic. No. r Class lor's Address Contractor's E-mail Address State �— Zip �— Telephoned EAR SETBACKS FRONTW, PERMITNO. X 7_4> I Ze�i EFT RFTRGr VCZ RIr WT e-, �•••• ....I "IN l.n C4n INV. I / f DEVELOPMENT NO — PLAN CHECK FEES $