HomeMy WebLinkAboutX2017-2688 - Permit Application_Tq gm�
Worksheet for Combo Building & Solar Permit Application
j Comm'I Residential City of Newport Beach - Building Division 3 =
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
"Building j Grading
rDrainage Elec Mech /Plum Cuydcut[— Cu Yd RllF_
114
Project Address (Not mailing address) f Flood (— Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use �w Const Type �—
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# Stories] I #Units (if Res)
--
I1
Valuation $I (j
Material/Labor
New/Add SF�—
Remodel SF I� Garage/New/Add �E3
OWNER'S NAME
Last jl;�lq�} First`
Owners Address
Owner's E-mail Address
21t 8
City
State �— Zip;CV_(�j Telephone
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address _
1\02 r-VNN
_ S�c�y�i2hl�y�rizr�-he`r
City I VV00-�)
State Zip Telephone' C714., e47—c<5V jO
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F= 772j(Q
Architect/Designers Address
11
Architect/Designers E-mail Address
it
City -- -
j
- - --State F Zip 11 Teleph�oneeF
ENGINEER'S NAME
Last I �I JP First J` ` J Lic. No. 1
i
Engineers Address
1
7
'/
Engineers E-mail Address S'� 7
City
r—i
State I Zip TelephoneF
CONTRACTOR'S NAME/COMPANY Lic.No.l V.d�l� Class
Contractors Address
Contractor's E-mail Address
State �-6d— Zip I Telephone
city '(C_ j - �� ��(`7�'1�f�o
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 1 7
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO- \r1 Z//6 — LOC 7
USE ZONE ._.. -
DEVELOPMENT90 PLAN" CHECK FEES.$,.. f���n