HomeMy WebLinkAboutX2018-2435 - Permit Applicationrm Worksheet for Combo Building & Solar Permit App
0 jr- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT cm
Building F_ Grading (-Drainage Elec r Mech
F_ Plum Cu Yd Cut F_Cu Yd Fill
Project Address (Not mailing address) I_ Flood
j" Fire F- Liq f- Landslide F_N/A Floor Suite No
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Description of Work
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Use F_ ConstType
Stories[ # Units (if Res)
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Valuation $ q,�r/ j/f -
Material/La/bor
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Remodel SF Garage/New/Add
New/Add SF a� 26��
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OWNER'S NAME Last 0 �� � TaAJ
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First o k � �{ G,A�e?ly
Owner's Address
Owner's E-mail Address
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City ;Jecye StateF
Zip p2Lo Telephone y q y30Z9�1
APPLICANT'S NAME Last
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First
Applicant's Address
Applicant's E-mail Address
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City q� / �G_S State ' �! Zip Telephone j 6Z `7e 5 3'�7SS
ARCHITECT/DESIGNER'S NAME Last �%/tI �� / vWt First F
�p t Q Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
.202-7 /c/. 2oss
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City SgNr.._,..-...,.... i. /i i1N,+ State �
Zip 92706 Telephone 5/I Y yC7Z..v78fj/
ENGINEER'S NAME Last �O� �q ,gym �n7
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First M4x � y Lic No. _ Ojo
Engineer's Address
Engineer's E-mail Address
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Aw*0,,nee 0Xgllvj •Camel
City F&/k4 d State [Z-1-�
Zip 1 Telephone 7d6 1/19- 262q
CONTRACTOR'S NAME/COMPANY /1,�5 v�� Lic. No. 76�!5 Classf g
U� f 7
Contractor's Address
Contractor's E-mail Address
0117
GS State
Zip �jDZ20 Telephone j 6 L 7 9S`s•7/S,s
FAR SETBACKS FRONT
PERMIT NO, X101'Z
SETBACKS RIGHT
PLAN CHECK NO. 10)$'6 - t7 tLA '
DEVELOPMENT NO
PLAN CHECK FEES $
I-AS-03L