HomeMy WebLinkAboutX2018-2490 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ,all
rl Comm'] rj Residential City of Newport Beach - Building Division
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Project Address (Not mailing address) ❑ Flood XFire ❑ Liq F-1 Landslide ❑N/A Floor Suite No
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Description of Work
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Use F]F ConstType
# Stories # Units (if Res)
New/Add SF � Remodel SF 3 � Garage/New/Add
Valuation $
Material/Labor .I�j
OWNER'S NAME Last (�First
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Owner's Address
Owner's E-mail Address
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City r�'�`/ P rJr,� �7E 4-State Zip TelephoneF
APPLICANT'S NAME Last �� (� First
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Applicant's Address Applicant's E-mail Address
PD 1'JOX 1�65� gjV��F{ •'F71�@ �M/�I` ,Gc�M
City - 1. _ I State ! --aZip -. -
2 � Telephone 9 246. i S
ARCHITECT/DESIGNER'S NAME Last "� �
- First 7F
- - — Lic. No. �l
Architect/Designer's Address Architect/Designer's E-mail Address
City i State [__7 Zip F j Telephone
ENGINEERS NAME Last First I I Lic. No.�
Engineer's Address Engineer's E-mail Address
City State F ] Zip [ Telephone
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CONTRACTOR'SNAME/COMPANY (�N%E h>U)L_D ZG Lic.No.�ry/(/t" 111 l Class�I
f J/�-J r ' ' 1
Contractor's Address Contractor's E-mail Address
City State Zip �— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $