HomeMy WebLinkAboutX2020-0457 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application 00 q.
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r" Corl Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES lAT TIME nF .¢i iPRAITroi
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Project Address (Not mailing address) Flood 17, Fire F_ Liq F-, Landslide [7N/A Floor Suite No
Description of Work
Use Const Type
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# Stories # Units (if Res)F—
Valuatio
Material/Ln 5
abor
New/Add SF f Remodel SFr Garage/New/Add
OWNER'S NAME Last I " i j First
Owner's Address At er-k$- Owner's E-mail Address
City State (�
--- --- __ Zip � Telephoned
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APPLICANT'S NAME Last i First '%ave
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Applicant's Address
Applicant's E-mail Address
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City ll tjgl .�Q tiLi State I v° t Zip �V �� Telep 72
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ARCHITECT/ ESIGNER'S NAME Last F �' First Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
city -.. State ��, Zip �� Telephoned
ENGINEER'S NAME Last First F Lic. No. ,
Engineer's Address Engineer's E-mail Address
City F_ .State �� Zip �� Telephoned
CONTRACYOR'SNAME/COMPANY PA
� Ssc�n �w Lic. No. Class C I
Contractor's AddressContractor's E-mail Address
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j
City State` Zipyy
Telephone
SETBACKS REAR SETBACKS FRONy'� I PERMIT NO.
STBA K LEFT SETBACKS RIGHT 1 PLAN CHECK NO.' i'':r'✓'',j a
USE ZONE DEVELOPMENT 0 �,�;�� F PLAN CHECK FEES$