HomeMy WebLinkAboutX2015-2422 - Permit ApplicationPrintFortn Worksheet for Combo Building & Solar Permit Application 94WDT�,N
I Comm I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding (-iGrading [-Drainage F-Elec rMech FPlum CuYdCut F CuYdFill l
Project Address (Not mauling address) [ Hood F Fire FI Liq F" Lalllllndslide F_N/A Floor Suite No
Description of Work
Use F ConstType
# Stories' #Units (if Res)._
r
Valuation $
Material/Labor
New/Add SFF Remodel SF -. 0 O Garage/New/Add �—
OWNER'S NAME Last _-- L First ��.�iJ/yi.
�/�
Owner's Address Owners E-mail Address
CR -- U tJ w -_. �j�j State ��- Zip F �2 Telephone
APPLICANT'S NAME Last First ..
f?sz /L--- ----
Applicant's Address Applicant's E-mail Address
f -77l_
City ti! State Zip qa(5'f 5 Telephone 9// 8.�0----5 c�a
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State Zip I Telephone
ENGINEER'S NAME Last f First f_- Lic No s-z_�'
Engineer's Address Engineer's E-mail Address �V-ID
City F_ State �---I Zip F Telephonel��`
CONTRACTOR'S NAME/COMPANY F%LWPS 7 Co,,S eur-7) Lic No. /3.-S uac&s
Contractor's Address Contractor's E-mail Address
77) --- -
City 2 // State C �} �/p
tlKl ` Zi Tele hone
/�T( p (o�G �c7 p S/-( -gad S/vc� V
9
SETBACKS REAR SETBACKS FRONT PERMIT NO. YZD I "J - Zy ZL�
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. ?N u_- ' 2,0 ( S
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $