HomeMy WebLinkAboutX2020-2860 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Per t Al 'catioln o��EW�Rr
r Comm'I I— Residential
City of Newport Beach - Building Division��
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building j— Grading [—Drainage r Elec j— Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) f— Flood f— Fire F Liq F— Landslide f N/A Floor Suite No
co v,F s
I� I�
Description of Work
Use ,�� Const Type
y �N��C E
`(V
INTO r
�� TO
# Stories ' # Units (if Res)
15T Fmdl'P- � I vA-t;I-E A
Valuation $ 9�
Material/Labor
New/Add SF 50 , Remodel SF
Garage/New/Add �—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State Zip Telephone
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State
Zip Telephoned-�
ARCHITECT/DESIGNER'S NAME
Last o�� First '� � Lic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City N, � State
Zip �� Telephone (�/ Zc^0- /,
ENGINEER'S NAME Last
First Lic. No.F�
Engineer's Address
Engineer's E-mail Address
City I -- State I.. _
Zip I Telephone
CONTRACTOR'S NAME/COMPANY 0 //i f $ekC"b Lic. No. Class
Cj7V
Contractor's Address
Contractor's E-mail Address
City a State v
Zip Telephone l0 6
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �•
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK N
USE ZONE DEVELOPMENT NO
PLAN CHECK FEE
E S $