HomeMy WebLinkAboutX2020-1150 - Permit Applications�
Print Form Worksheet for Combo Building & Solar PermitApplication?EWPore
City of Newport Beach - Building Division s
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Comm" [- Residential x NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U a
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❑Building F' Grading rainage KEIec Mech [ Plum cuvdcutr_7 cuvdFill
Project Address (Not mailing address) ❑ Flood [ Fire C; Liq [ Landslide ,[V/A Floor Suite No
cription of Work Use Const Type
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# Stories[ # Units (if Res)
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New/AddSFF- Garage/New/Add _7111
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
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City State - Zip �; Telephoned
- -- -
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
- --
City State Zip Tele Phone� (� V-_
ARCHITECT/SAME Last - First Lic. No.
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Arhitect/Designer'sAddress Architect/Designe'sE-maill dress g�
City State Zip Telephone `_��
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's E-mail Address
City --------- --_ State F Zip Telephone
CONTRACTOR'S NAME/COMPANY / ti Lic. No. r3b0---- lass
Contractor's Address Contractor's E-mail Address
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Ci O t / J +E�ev.._ State Zip .. p �.7[ Y. Telephone G6_ D 7- t 9z
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ um