HomeMy WebLinkAboutX2014-0839 - Permit Applicationio
Wor heet for Combo Building &Solar Per it Applicatio
r comm'I r sidential City of Newport Beach - Building Division y t/ jLillI
r� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM AL
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Project Address (Not mailing address) Flood r Fire ri Liq Landslide rIN/A Floor Suite No
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Description of Work
Use Const Type
# StoriesE # Units (if Res)[7
5 Lr
Valuation 6o0 6100
7079
Material/Laa bor /
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New/Add SF Remodel SF � Garag a/New/Add
OWNER'S NAME Last First
Owner's Address Owner's E-maiill Address
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City State r� Zip Y Telephoned
APPLICANT'S NAME Last 4d&x
Applicant's Address Applicant's E-mail Address
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City T„val- ( State Zip Z 07" Telephone C'# $M/•p -S
ARCHITECT/DESIGNER'SNAMEt�cII Last FirsLic. No. G
Architect/Designer's Address .ice - Architect/Designer's E-mail Address
City State Zip Telephone J
ENGINEERS NAME Last r ,�,J First/yam J Lic. No.
- Engineer's Address Engineer's E-mail Address
efm E AA- 1
City KPrlyt State Zip 'Telephone 7 777^72190
CONTRACTOR'S NAME/COMPANI( Lic. No. E ClassF—1
Contractor's Address or's'E mail Address
J
City State Zip Telephoned
SETBACKS REAR S SETBACKS FRONT Lp PERMIT NO.
SETBACKS LEFT 3 SETBACKS RIGHT PLAN CHECK NO. ®� •',�t%
USE ZONEDEVELOPMENT NO PLAN CHECK FEES $
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