HomeMy WebLinkAboutX2016-1151 - Permit ApplicationlaC 5
Print Form Worksheet for Combo Building & Solar Permit Application 06,
Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r'Building rGrading
Cu Yd Fill
Drainage rElec F_Mech rPlum C;1�1Utn5dslir-NIA
Project Address (Not mailing address) r Flood r Fire r Liq Floor Suite No
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es5fiption of Work
Use r- ConstType
# Storiesr— #Units (if Res )F
Valuation$-
Material/Labor
New/Add SFF_
Remodel SFF —', Garage/New/Add F_
OWNER'S NAME
Last _+'�e`t \ 1_e',. First
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Owner's Address
Owner's E-mail Address
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City e �rV
State L0. Zip z(,,�U Telephone
APPLICANT'S NAME
Last -.L.�c _Y�. First
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Applicant's Address
Applicant's E-mail Address
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City \
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State c' Zip Telephone
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ARCHITECT/DESIGNER'S NAME Last PC First r 0 — Lic. No. F—
Architect/Designer's Address
Architect/Designer's E-mail Address
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1
city � LLrIC( �'1 State Zip /i[ W Telephonew `5/_91W.
ENGINEER'S NAME
Last First F_'. Lic. No.�� —
Engineer's Address
Engineer's E-mail Address
City �—
State �— Zip Telephoner
CONTRACTOR'S NAME/COMPANY 1 bSt- L� J 5�®�_ Lic. No. ��7�y Class
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Contractor's Address
Contractor'r's E-mail Address
1-7 PrM 6Yo•!;e—
CityF�,ej _0 P6
State �'r_ Zip i�Z��'7 Telephone
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. �C(�.l p�✓I �%I
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 040 - W I Gj
USE ZONE
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DEVELOPMENT NO.1� W 5_01 (qp. PLAN CHECK FEES $