HomeMy WebLinkAboutX2015-0466 - Permit Application� U Ia K2D0-
Worksheet for Combo Building & Solar Permit Application
Comm'I Residential /��\\ City of Newport Beach - Building Division
1 X J NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Building Grading [Drainage VElec -.lvlech Plum cZeL%dslide
Project Address (Not mailing address) C Flood [—i Fire Liq _N/A Floor Suite
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Description of Work
Use 35ConstType I
w7 9
# Stories #Units (if Res)
WPAVT
Valuation $ cfi
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New/Add SF�— Remodel SF Garage/New/Add
Material/Labor �Q�Q
OWNER'SNAME Last - J First
Owner's Address Owner's E-mail Address
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City /V e �r" _ -- K —7 ak State Zip Telephone
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APPLICANT'S NAME a
Last ��(' -_ First
Applicant's Address Applicant's E-mail Address
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City ._� Pe�—J State LC, �f- J Zip �J Telephoned 0�
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ARCHITECT/DESIGNER'S NAME Last _-�Q,,,,, . __ --- _ _-,. First _- �F�-Oa n s Lic. No.
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Architect/Designer's Address Architect/Designer's E-mail Address
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City State Zip Telephone4.1
ENGINEER'S NAME Last - ' 'fin First _ -_ _�f�-� 05 Lic No.
Engineer's AddressEngineer's E-mail Address
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City - /r, r J State FW J Zip �� ('fi7 Telephone ��l,.a�Yla
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
City < State Zip I r �UV� J Telephone �s J Z
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ OL42 9 '1A11S
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