HomeMy WebLinkAboutX2017-2449 - Permit ApplicationWorksheet for Combo Building & Solar Permi lica 0"'!
Comm'1 Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r-Grading rDrainage F_Elec F-Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood r Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use -j ConstType Vb
tklC'ikj.7 CA , ,ban a ]� xk e,, DP— P0 21' () +o 'pAwtr
# Stories # Units (if Res)T
Valuation $1 B
Material/LaborFA;V
New/Add SF Remodel SF 7— Garage/New/Add F—
G�
OWNER'S NAME Last N� First
OwnersAddress Owner's E-mail Address
i'l rD2 .
city rrvil - bnk _ State F� Zip TelephoneF—
APPLICANT'S NAME Last I I First
Applicant's Address Applicant's E-mail Address
� !NRE31n GNeA gip, Q likA0 u,IA� �!C� t�la l
City N���. cIL _ _ State � Zip qttOLQ.(J
�'Telephone _qL(q = �51 -OL(I'
cQ i `I 1
ARCHITECT/DESIGNER'S NAME LastCA ' First �Q S Lic. No.F(,A
Architect/Designees Address Architect/Designer's E-mail Address
City olzmatY,ok State F� Zip Iqyo(Q�o Telephone -j 5?-0`1
ENGINEER'S NAME Last '�VbOYU��-�9'I/'l First j") Lic. No. 2- &
Engineers Address Engineer's E-mail Addf'ess
2119,6-t 6(xw oe _ i00
City _ _ State I -X Zip I -� Telephoner Q-•o`�`�
CONTRACTOR'S NAME/COMPANY �Pl� b(it Lic No. 5S 1 q0 Class)
Contractor's Address Contractors E-mail Address
city U2,4u . State I -'� Zip q' RS TelephoneICt633-4&7�
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. I -
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $