HomeMy WebLinkAboutX2018-1826 - Permit ApplicationFirst
Owner's E-mail Address r-�—
ZIP I I Telenhnnal I
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Applicant's E-mail Address
ZiP Telephoned
Last F_-. _— - _ _ _71 First
Architect/Designer's Address
City State L J
ENGINEER'S NAME Last
Engineer's Address
Lic. No.
Architect/Designer's E-mail Address
Zip Telephoned
—1 First F77777 Lic,
Engineer's E-mail Address
City _ State �� Zip L J Telephone
CONTRACTOR'S NAME/COMPANY
Print Form Worksheet for Combo Building & Solar Permit Application
❑ comml Residential City of Newport Beach - Building Division
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
3i1uilding f ,Grading ❑IDrainage lf�Elec
Project Address (Not mailing addre:
t � F6 swfi-C� _DV,
Description of Work
5�Mech ('Plum
❑ Flood
Cu Yd Cutl Cu Yd Fill
❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
JU,e OK ConstType�
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# Stories # Units (if Res)❑
New/Add SFF_I Remodel SF ��Y(Tp� Garage/New/Add F II IMaterial/Labor
Va ion 5
OWNER'SNAME Last�j�v6
Owner's Address C
City _- _- _ _ --_ State
APPLICANT'S NAME Last
Applicant's Address
City State ��
ARCHITECT/DESIGNER'S NAME
_ Lic No. ;stl47 Class C
Contractor's Address
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
Contractor's E-mail Address
Zip F Telephoned
PERMIT NO. AU-6 ' t $i to
PLAN CHECK NO. 8,LQ1 1 14
DEVELOPMENT NO
PLAN CHECK FEES $