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HomeMy WebLinkAboutX2020-0943 - Permit ApplicationPint Form Worksheet for Combo Building & Solar Permit Application flod� Comm'I [ Residential City of Newport Beach - Building Division �j�0— � 1(� NOTE: PLAN CHECK FEES nI IF AT TIMF nF aI lanniTTAI KBuilding ❑Grading ❑Drainage AElec AMech 1Y Plum CuYd cut JJCu Yd Fill Project Address (Not mailing address) [ Flood ❑ Fire ❑ Liq ❑ Landslide (-JN/A Floor Suite No 00 /Il a �R • C _ ✓, la Gar ! _ 1 Description of Work b �j - 0 *-U [ AK1 t✓ A AL /� ' �flxR� G CIS ��G%N - Use I onstType 14� �� OR i O i A Il # StoriesC # Units (if Resci Valuation $ New/Add SFF Remodel SF -I Garage/New/Add Material/Labor OWNER'S NAME Last��� First _- ----� �-t{}✓ • ({ Owner's Address Owner's E-mail Address ' <j tj 4 City �T�IJ�Pi i --- State �� Zip y Telephone U APPLICANT'S NAME pj j� Last`' 1------- First --- -----� Applicant's Address _t Applicant's E-mail Address LA City LORM4, i state C a` I Zip z�OQ TelephoneyO -�T ARCHITECT/DESIGNER'S NAME Last —1 First �4L i —� Lic No. Architect(Designers Address Architect/Designer's E-mail Address f City I low w �- - � /rc � State �! zip 'Z6fj [f Telephone Q T/5.6�I el 4 ENGINEER'S NAME Last _ _ _ - -_ First F j Lic. No.F—I Engineer's Address Engineers E-mail Address City State j Zip Telephone CONTRACTOR'S NAME/COMPANY - I U �� PM� j Lic. No.Class l Contractors Address tt uw "j�xw does E-mail Address tillpNI City-" State Zip M2 �.21L Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. x�/� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. f' l h73 ZOZ USE ZONE DEVELOPMENT NO PLAN CHECK FEES $