HomeMy WebLinkAboutX2015-3696 - Permit ApplicationWorks eet or Combo Building & Solar Permit Applica - n a
rl Comm'I Residential City of Newport Beach - Building Division =(�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL~
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Project Address (Not mailing address) [� Flood - � Fire Liq Landslide ❑N/A Floor Suite No
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Description of Work
onst Type
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1_0 ✓N � �OC rI � � IN.
# Stories�Units
Valuation 5�
Material/Labor
(if Res)
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New/Add SF�I Remodel SF� Garage/New/Add ��
OWNER'S NAME Last 'v c v- First
Owner's Address Owner's E-mail Address
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City . L State ( I Zip Telephone __`LL k5
APPLICANT'S NAME - LastFirst yr —
Applicant's Address Applicant's E-mail Address
City l' I, �GG�Yt�`C State 7Zip., _ 7 o_ Telephon ��. ;. , _ ( 3 o 7
ARCHITECT/DESIGNER'S NAME Last First Lic. No
Architect/Designer's Address Architect/Designer's E-mail Address
City WAS I .l State Zip 'G�7 �3 1 Teephone (. v — 2�1 -
ENGINEER'S NAME Last J First! , Lic. No.�,
Engineer's Address Engineer's E-mail Address
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City State Zip) Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. `/�Gf Class [3
`51' L �, _
', ontractor's Address Contractor's E-mail Address
City �i� �y State Zip F Telephon
SETBACKS REAR SETBACKS FRONT PERMIT NO. ;)��[.et's./rlrcll.../�
SETBACKS LEFT \ SETBACKS RIGHT PLAN CHECK NO
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $