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HomeMy WebLinkAboutX2018-1559 - Permit ApplicationX 20 I� A 1jr_,�I ;orksheet for Combo Building & Solar Permit Application 04,7M,, alCity of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ading j-Drainage r; Elec (-; Mech j—I pi d Cut 1 Cu Yd Fill v� ess (Not mailing address) F Flood Fire F Liq dslide f-.N/A Floor_ Suite No Ca,¢S'j 14 wtv ,h of Work / Use I'-- I ConstType -Wba/ /6 �ir�ia C iA�� l cx U✓/1-� # StoriesT # Units (if Res)�� -- /Add SF l Remodel SF Garage/New/Add 7_77 Valuation $ /�D Material/L or / OWNER'S NAME Last ���-�,/�/� First Owner's Address Owner's E-mail Address City T� RORT BF ---- State F—I Zip Telephone APPLICANT'S NAME Last First lf'iXe005-LO Applicant's Address Applicant's E-mail Address /52 DPAWi 0K. z City ( tp_✓/N State — Zip 261� - Telephone -- - ARCHITECT/DESIGNER'S NAME Last /jt#j�, Firs/�%/f,��ELt� t Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address �/52 py�acr� oR. �55 e . a% .Hail c®� City State Zip Telephone ENGINEER'S NAME Last ,I(/�(,�_ First!W/L/Lic. No. - -- ---- I Engineer's Address Engineer's E-mail Address 15.70^,e,�jy��rl�r� D,e. City c�j�/fl�"�/ /��(%�' State �i ZIP 1 4127 Telephone / 6_2 -O_/_ CONTRACTOR'S NAME/COMPANY Lic. No. Q�7©� Class Contractor's Address Contractor's E-mail Address 3. �ewh'w� S tTe_ J 0 City T t� State �-? J p Zip 1 l8 Telephone q0q F((qx SETBACKS REAR f O� SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO PERMIT NO. ZOO. ' PLAN CHECK NO. S PLAN CHECK FEES $ tb-° l r•