HomeMy WebLinkAboutX2015-3753 - Permit Application,4\,YP04
Print DormWorksheet for Gou-nhu Building & Solar Permit Application
Residential City of Newport Beach - Building Division -3
Comt-ri'l )( �to\l; - 31�7
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
jay Ll i I d i n g Grading I" -Drainage I`— Elec I-**- Iviech Plum CuYdFill
Project Address Not mailing address) I- Flood F Fire Liq Landslide Floor Suite NC,
Description of Work ---- ------- --- Use Const Type
# Storiesi # Units (if Res)�
ATE
Valuation
New/Add SF Remodel SF ~ Garage/New/Add Material/Labor
OWNER'S NAME Last L FirstI
Owner's Address
City
APPLICANT'S NAME
Applicant's Address
City
Last Fbe.)o
ARCH ITECT/DESIGN ER'S NAME Last
Architect/Designer's Address
City
lfN61NEEWS NAME Last F--
Engineer's Address
INTRACTOR'S NAME/COIVIVANY
5 Address
IS t,710011"IF
Owner's E-mail Address
State zip Telephone I I qq
State FCA
First hry �O,
Applicant's E-mail Address
[T
Zip Telephone 7(t �7 4)q
First Lic, No.
Architect/Designer's E-mail Address
State I Zip F—'---- - TeIephoneF________ -
First
Engineer's E-mail Address
State F- Zip Telephonel
Lic. No.1
C (910 �A N PId IAIC. Lic. No. Class Contractor's E-mail Address
State A Zip Telephonebfv
REAR SETBACKS FRONT PERMIT NO.
LEFT SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $