HomeMy WebLinkAboutX2020-0135 - Permit ApplicationPrint Fdtm Worksheet for Combo Building & Solar Permit Application
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F-Comm'I r Residential City of Newport Beach - Building Division X ®O�i� 3 ik
.NOTE. PLANCHECK. FEES DUE AT TIME OF SUBMITTAL 5<..0.�•'
rBuilding r- Grading F -Drainage 'r-Elec r Mech r Plum' CuvdCut F CuvdFill
Project Address (Not mailing address) F7 Flood F_ FireLiq r- Landslide rN/A Floor Suite No
Description of Work J�i
Use Const Type -
3 b rl to l 4 LA j�LeC
IF -I oriesF_ M Units (if Res)F
Fvt �4f e4t., h
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Valuation $
Material/Labor 21Gt �
New/Add SFF—.---77 Remodel SFf -.-- -�_-�_ Garage/New/Add
OWNER'S NAME Last y g First �ctA
Owners Address Owners E-mail Address
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City ETUT5 State ,ziP `� C J Telephone_ �I `F-
APPLICANT'S NAME - Last First C
Applicants Address Applicant's E-mail Address -
City P11 State 1 0 ! W Zip �Z6� j Telephone
11./ 'T ( 7 7� 1
ARCHITECT/DESIGNER'S NAME Last f --'- - First F'--
Lic No.
- ArchitecVDesigners Address - Architect/Designers E-mail Address
City F State �� Zip Telephone---- -
ENGINEER'S NAME Last G c C L C v� First Lic. No.FC
Engineer's Address -7-C1 jJ �TI-d-f Engineer's E-mail Address
City F�r, IAA State C Zip -('Z5--r- Telephonerr 7
CONTRACTOR'S NAME/COMPANY �-T Lic No. OY S L Class
Contractors Address Contractor's E-mail Address
E S W e,,v 0 r Z q.
City ` 3 State CV9� Zip F9-4663 Telephone Ctq 9.01 L( 3
SETBACKS REAR SETBACKS FRONT PERMIT NO
'SETBACKS LEFT - SETBACKS RIGHT PLAN CHECK NO.-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES '$