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HomeMy WebLinkAboutX2020-1608 - Permit ApplicationPrint Form _ p Worksheet for Combo Building & Solar Permit Application F Comm'IResidential City of Newport Beach - Building Division Y r/1�]I� _* 6� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI A � o }Building F_ Grading r -Drainage Plec J_Mech [KPlum cu Yd cut F16 Cu Yd Fill Project Address (Not mailing address) F Flood _ Fire )� Liq F Landslide I_N/A Floor Suite No r r Description of Work Use W-9 Const Type (Wm-(Zic-tL ` ® lyL�u is �, 1 #Stories #Units (if Res) ` � t'l. 131 .r y--� �2�A !•—"'tr%�sj� valuation $ %t �; 6' i�d Material/Labor �t;-L,sz� New/Add SF� Remodel SF I d -7S "a 2 Garage/New/Add a/New/Add �� g OWNER'S NAME Last M�1zV�iJ First Owner's Address Owner's E-mail Address Z- o �e W GU,C ad 1.1 0 Ai2VyT1 c,,,44, e �ics0� City POl.Jik411 State Zip Telephone[`7—F� �, X72' 83 b APPLICANT'S NAME Last M V t 4`t First' to to Applicant's Address Applicant's E-mail Address G0{u,tAOM ,FoNA4zWiN(20,' 6­r7�-L_ City fJ „t;J1r0���---i- i,�cC State (5 Zip g7_k>E,( Telephone '2-�-,7- &7I- 53 IS je-, ARCHITECT/!SIGN WS NAME LastF5 t16 -./'1$ First L2D^k-1 Lic. No. F_' Architect/Designer's Address ArchitecUDesigner's E-mail Address City F(-;&I—/1—State ........_ Zip 2-7 Telephone I$ �Lf�epi/j2 r� ENGINEER'S NAME Last o i4, cr First (Q -F3 Lic. No.7— Engineer's Address Engiineeer''s E-mm�jail Address ��,+ L �p tf_ F d./` A' llN o"-oly &r ( '- { v. 1.7 / 9 1` 4-v+ kJ i t�/� ) City i &A State Zip c%L%0; Telephone 1 CONTRACTOR'S NAME/COMPANY Lic No. Y(3 65�lass Contractor's Address Contractor's E-mail Address City F State r Zip r— Telephoned SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $