HomeMy WebLinkAboutX2018-0041 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
/ F Comm'I residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL uC5</F00.�
r uilding j_ Grading F—Drainage j_ Elec (— Mech Plum Cu Yd Cut i Cu Yd Fill
I F
Project Address (Not mailing address) F7 Flood r— Fire r— Liq j Landslide I N/A Floor Suite No
12 4 A fd caa
IG,
Description of Work Use �� Const Type I
# Stories; 7#Units QfA9es)jq
New/Add SF� Remodel SF 4 Valuation $
I 7C 5 y/. Garage/New/Add) �® Material/Lab�Cl,
OWNER'S NAME Last F First '
I VA CGS
Owner's Address Owner's E-mail Address
12- Cocx-60 e!�� 6M64eW,
City e /QGa rf ��� State Zip °%Z(O S Telephone
��V - 9y9_7ts"7Z16
APPLICANT'S NAME Last yy1 6%,v,i , First i �1JUVS
Applicant's Address Applicant's E-mail Address
City L�,� ,p 5 or C State ��T Zip qO2 ;7 Z Telephone J? /p, 3 p f c�0 aj
ARCHITECT/DESIGNER'S NAME
Last � First I Nij ilS' LG ' Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
ne
%t fiuc j�oUS�ic� �/4,,eeS kcto s Co
City P�G� �SA State �! Zip Cap Telephone)
ENGINEER'S NAME Last H 01,,k'KA First , Lic. No.r 1,
Engineer's Address Engineer's E-mail Address
�-'FNkNE IIG1NCEA.Il1lCO AA
city r ; yl State F- Zip c,;�2 461 Y` Telephone 94 9 , 24 5 _ $ 0 p <9
CONTRACTOR'S NAME/COMPANY Lic. No. Class��
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Contractor's E-mail Address
i
State � Zip � Telephone
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO. \14-1 3`i-1g, ndLy k
PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $