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HomeMy WebLinkAboutX2016-2959 - Permit Application (3)z�t/z 20(6 Worksheet for Combo Building & Solar Permit Application City of Newport Beach - Building Division r Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Bull /c}m�g r- Grading Project Address Q a (a/ . of Work lr+ �2 u I L (31 [—Elec F_Mech F_Plum Cu vd Cut Cu Yd Fill (` Flood r fire r Liq r Landslide F_N/A FloorSuite /U 2l� T_t�P_-- $ pCr'_j&5' New/Add SFF— Remodel SF Garage/New/Add Use Const Type r # StoriesF # Units (if Res) Valuation Material/Laa bor OWNER'S NAME Last VV(� (7 Td !` First I �'( (M CC (Q .� Owner's Address Owner's E-mail Address 3-7 C!!PfF DD0c-Z- J�lAA@UJAV2I1\It3EjIRY'IGso0,Q CavtA City State Zip 2 &C Telephon J7q - qq i J _ 2 APPLICANT'S NAME Last W / ' rq ( N 5 ' I o K First T (M CY2 Applicant's Address 37 cNa- City IV -,2, State ARCHITECT/DESIGNER'S NAME Last I O L!�: f-7 rJ Architect/Designer's Address 2 S_l-5- (0�-- - `e- P-2-- - ENGINEER'S NAME State Applicant's E-mail Address fflP101 zvvtt�+R/LCN C�1n Zip ( Telephone %(yam �{74-� 3 Zip Fq First E ( Lic. No. F - Architect/Designees E-mail Address �2(c_(�? F kt " dLSllPl>e5c Zip FqZ� . - Telephone) 1q ( - 887`g0 ^fo Last Fe4r-o ✓ First F Engineers Address 2 3jj /y© {�� � roc_ [�St City TZI ,(-cq+ StateI CONTRACTOR'S NAME/COMPANY Contractor's Address Cf c-0�t s E State F 'S REAR SETBACKS FRONT LEFT SETBACKS RIGHT Lic. No. 73 �? l )- Engineer's E-mail Address PVP�t ry� V @ Zip � �o Telephon y' `YGI} x -77? C'c , I / 7 Class F Contractor's E-mail Address -J-", -,- c� Zip F '1 6 .6 Telephone 7(y- q 3 t/ tl V�3 1, i" M PERMIT NO. (N6G� ^00V I PLAN CHECK NO. DEVELOPMENT NO �( - 5PLAN CHECK FEES $