HomeMy WebLinkAboutX2017-2987 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F Comm'I . Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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XBuilding (— Grading F-Drainage J� Elec F_ Mech K Plum Cu vd cutF Cu Yd FIT
Project Address (Not mailing address)WP F_ Fire Liq F_ Landslide F_N/A Floor Suite No
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Description of Work
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Use F Const Type
CI a "{ OVA rx & I kk k(,Aie� n Ce/� Pl
# Stories # Units (if Res)F
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Valuation $
Material/Labor 5-o)196)0 �I
New/AdddSFF—Remodel SF is Garage/New/Add
OWNER'S NAME Last I N6LSAj First I IF, D
Owner's Address ( a$ C I N G) Owner's E-mail Address
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City - State Zip - ��7 Telephone �/cf �y_g��g
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APPLICANT'S NAME Last jr$ N-S "'j First h.
Applicant's Address Applicant's E-mail Address
7351 -r✓, CA-I.(,� Due,AnJvo g✓k�vi, �°�b,rrm-,5o®�,m�,�,-,
City �}�kg/�. State Zip ga.pOt? Telephone 7/Uq3/-t%jj09
ARCHITECT/DESIGNER'S NAME Last C0127 F Z. - First __ 97"GI`W ii -- Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City _-- . _ State F� Zip �r/� / Telephone 7j(,� d.)� 5
ENGINEER'SNAME Last n �{% _ -- First #nC/j- Lic.No.0 I9I999
Engineer's Address Engineer's E-mail Address
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City State F_. Zip F— Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. Class
- - -- - �--� �—
Contractor's Address Contractor's E-mail Address
City _. State Zip! Telephone—
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1/(Jl,p�2,ayt/ IC
USE ZONE - DEVELOPMENT NO PLAN CHECK FEES $