HomeMy WebLinkAboutX2016-2908 - Permit Application/ 7) 3 000� nolu �
PrL cFo�m Worksheet for Combo Building & Solar Permit Application nolw,.)❑ Comm'I [j Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building ❑Grading ❑Drainage ❑Elec EMeth ❑Plum Cu yd Cut= Cu Yd FRI 17,11
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
Description of Work
Use Const Type
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A� -� �-�•� � a r tkh +(tea ^C-'a
p Stories 6 Units (if Res)r!!
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Valuation $
Material/Labor
New/Add SF t i Remodel5F til Ip Garage/New/Add ��, �
OWNER'S NAME Last --��,'t�e �I First
Owner's Address
Owner's E-mail Address
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City �s Q,a.� State 74�\11 Zip - Telephone[:7�
APPLICANT'S NAME Last _
First
Applicant's Address Applicant's E-mail Address
I
I
City State Zip �' Telephoner--
ARCHITECTlDESIGNER'S NAME Last j ,� i First i
QX Last;Lic. No.
ArchitecYDesigner's Address Architect/Designer's E-mail Address
City C�Z pr��� State C+� i Zip Telephone
ENGINEER'S NAME Last First Lic No.
ngineer's Address Engineer's E-mail Address
City;' State Zip i Telephoned
C
CONTRACTOR'SNAMEXOMPANY i1 l � Lic. No. l'6j,q Cp�s�;
Contractors Address Contractor's E-mail
1Address
`it'I a nek%A ',re Q0k, C,_P V__N
�ry
City C.�`-�( C,4 State 'E/- 1 ZIP H � Telephone q t q_ L( I g _,� Cy 26
SETBACKS REAR SETBACKS FRONT PERMIT NO. p) �y 4
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE - DEVELOPMENT NO PLAN CHECK FEES $