HomeMy WebLinkAboutX2020-1916 - Permit ApplicationPrint FormWorksheet for Combo Building & Solar Permit Application Vf— Comm'I f,Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X�2o
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Description of Work
Use I Const Type
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Valuation T
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OWNER'S NAME Last ✓*�Qt! ,, First D Gi VLA
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Owner's Address
Owner's E-mail Address
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Zip Telephone
APPLICANT'S NAME Last SOI�Wj�I✓✓f__._
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Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last
First F Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City State
Zip—i Telephone
ENGINEER'S NAME Last
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State F
Zip I Telephone
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CONTRACTOR'S NAME/COMPANY J � Wv/)
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Contractor's Address
Contractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. iX -7 LD W -
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1 Ly3 . -,7 C n
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES F�