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HomeMy WebLinkAboutX2020-2164 - Permit Application (2)Print Form Wor eet for Combo Building & Solar Permit Application p* WAR _ „a F- Comm'I F- Residential"7 City of Newport Beach - Building Division 2V2_ ' 7-1)aLI o NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G aa•" F -Building r Grading rDrainage j(Elec FMech rK Plum cu vdcutF Cu Yd Fill Project Address (Not mailing address) F_ Flood F- Fire r Liq r Landslide FN/A Floor Suite No Co ! ( L 00 G C2,ntjvrs N H f cD4k I �— F— Description of Work �.� Use ConstType ll ' NO S i rVCT- rr.�L: N�Uv KI r �5, # Storiesy6 # Units (if Res)[_ (J 9 D N� s I,I ptn� (:7j5 Valuation New/Add SFF _c5 Remodel SF /d_j p Garaga/New/Add F 5 $ jam Material/Labor OWNER'S NAME Last I � First 'H (5 (r-) Owner's Address Owner's E-mail Address City r _-- State I-_ Zf Telephone APPLICANT'S NAME Last M6 5s 4A9�,ry First �) G Applicant's Address Applicant's E-mail Address City State f— Zip F_ Telephoned ARCHITECT/DESIGNER'S NAME Last Lic. No. FC—71,7/ Architect/Designees Address Architect/Designer's E-mail Address 2qO W, 7,z;:,�,W 123 t rvnn5M-A^lP6()�WIL,, cxr7 \ City / P State �� Zip \� 63 Mone�� (� � (J — 72� Z ENGINEER'S NAME Last First F Lic. No.1 Engineer's Address Engineer's E-mail Address City State F Zip F— Telephoned CONTRACTOR'S NAME/COMPANY ✓� �/�2 "'Z� Lic. No.F7 14;A�e Class I `-" Contractor's Address Contractor's E-mail Address City State F_ Zip F Telephoned w SETBACKS REAR SETBACKS FRONT PERMIT NO. / SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. / (A V ) USE ZONE DEVELOPMENT NO PLAN CHECK FEES $