HomeMy WebLinkAboutX2020-2831 - Permit Application1 Print Form j Worksheet for Combo Building & Solar Permit Application
oew Newport Beach - Building Division
Comm'I r City Residential f Np SC NOTE: PLAN CHECK FEES DUE AT TIME
OF SUBMITTAL
v
F_Building r Grading F-Drainage F_ Elec F Mech F- Plum CuvdCut CuvdFill F
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use Const Type r
'rtiT -
r
r�(� ,
r
#Stories #Unit=(if Res)
Valuatior—
Material
New/Add SF� RemodelSFFGarage/New/AddF—
OWNER'S NAME Last
L First7�` t
l
Owner's Address
Owner's E-mail Address
City I I
State Zip ;� Telephone �1q71j,
APPLICANT'S NAME Last
I CFirst �� J7
_
Applicant's Address
Applicant's E-mail Address
�I
_
City ; ' e. hJ Jfl 1 ri7 State �_ /I.L Zip (7 S Telephone 47 Lr �j
ARCHITECT/DESIGNER'S NAME
Last First F_
Lic. No. F_
Architect/Designer's Address
Architect/Designees E-mail Address
City 7— -
State F_ Zip F Telephoned -
ENGINEER'S NAME Last
First Lic. No.F
1
Engineer's Address
Jl/
Engineer's E-mail Address
City
State F Zip F— Telephone)—
CONTRACTOR'S NAME/COMPANY
!-. ( Lic. No.'G� L Class L-b7
�N
Contractor's Address
Contractor's E-mail Address
CAL
City `�,h_
State Zip T7k--7, Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
7�
SETBACKS RIGHT PLAN CHECK NO -
USE ZONE
DEVELOPMENT N „ �� I�IPLLAN CHECK FEES $