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HomeMy WebLinkAboutX2015-3325 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application Comm'I ;Building F Grading Drainage Fi!Elec I - Meech f Plum Cu vd Cut" Cu Yd Fill I Project Address (Not mailing address) ❑kood C Fire F_ Liq F-] Landslide -- /A. Floor Suite No �% /lY� FL OG A%o //'l!/iT^ ��2 / . `� � Description of Work , Use I Const Type r-J Storie�# Units (if Res)r_l Valuation $ New/AddSF_- f —I Remodel SFF_ ::�7 Garage/New/Add -- Material/Labor s �� OWNER'S NAME Last Owner's Address Owner's E-mail Address City - -J State Zip I I Telephone J APPLICANT'S NAME Last First Applicant's Addressj/%%[!_Gr✓��iu`r�v�iu�pxeayii'y'f(�'2il Address city �% _ - _ - J State Zi Telephon _ - - 1. ARCHITECT/DESIGNER'S NAME Last First F Lic. No. Architect/Designer's Address A 2, itect/Designer's E-mail Address l City 49, State - Zip F Telephone I ENGINEER'S NAME Last F First Lic. Ne,944� Engineer's Address Engineer's E-mail Address City J State Zip ; Telephoner— CONTRACTOR'S NAME/COMPANY CGw��I/�i Lic. No. �y Clas5FZ7 Contractor's Address Contractor's E-mail Address - - -- --��i- City e7IAA,759- Y State Zi elephone SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ (! Residential City City of Newport Beach - Building Division Mi`I�� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL m-