HomeMy WebLinkAboutX2017-3114 - Permit Application4wo/- ru4t . A
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Workshee fo Combo Ildlng & Solar Permit lica i n
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I Comm I I esidential City of Newport Beach -Building Division 5
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j -Building r✓ Grading F-Drainage F_ Elec F_ Mech (-" Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood f—Fire [—Liq r- Landslide /A Floor Suite No
Description of Work Use Const Type
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� # StoriesT�'#Units (if Res) _
U_.) r / A-1_4 6-I)T96M P&I-41
Valuation $
New/Add SF Remodel SF Garage/New/Add Fig) ) Material/Labor r
OWNER'S NAME Last ��' �.� First (�� L L
Owner's Address ' /•L' Owner's E-mail Address
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City (/" �/�-� aps State • Zip Telephone I (A _16
APPLICANT'S NAME Last I 6��� First '
Applicant's Address
110(01 f.41,1
City & 13 r/ �d fime4l-State
N�AIAME Last
Arch itect/Designer's Add ess
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City f p State d
Applicant's E-mail Address
Zip Telephone •-
First, 0 v ti Lic. No.
Architect/Designer's E-mail Add es
14, Rr
Zip Telephoners f (C�
ENGINEER'S NAME Last % %�-1 First 14 14 / Lic. Nol /,
Engineer's Address
I/ 1ne; 066
City A t T A State CA
Engineer's E-mail Address
Zip 12. L ® Telephoneill I V -&kl - 05 l t)
CONTRACTOR'S NAME/COMPANY Lic. No. Class I�g
Contractor's Address Contractor's E-mail Address
City -- �fLLw�'G State �� Zip Telephoner—
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SETBACKS REAR
SETBACKS FRONT
PERMIT NO. �7 o 16 J q 2i-7
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. �L ✓ 7 ' cJ
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ `H S , Z _c r' •J