HomeMy WebLinkAboutX2020-2335 - Permit ApplicationnntFot7!,. Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach -Building Division 42
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI AL 1J
wilding ❑ Grading j ,'Drainage ❑ Elec n Mech F Plum cued cut Cu Yd Fill
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Project Address (Not mailing address) ❑Flood j-) Fire[- Liq F_I Landslide ]N/A Floor Suite No
Description of Work Use Const Type I
#Stories #Units (if Res)�II
� Valuation $
New/Add SFRemodel SF Garage/New/Add L Material/Libor
OWNER'S NAME Last �-1 FV4
First I
R(./ c� r�va -- - --- --i -- -- - -- - - -- —2GI ` 0
Owner's Address Owner's E-mail Address
City -Iv - - -- -- - - StateUt_j ZIP Q Telephone
APPLICANT'S NAME Last I f 4AA,:',I ,k' r%41 A r2 K— I- 1 First
Applicant's Address Applicant's E-mail Address
Pk- 67V co
City I StateG Zip G Telephoi
ARCHITECT/DESIGNER'S NAME -- Lic. No
Last First i
Architect/Designees Address
City � State I
Architect/Designer's E-mail Address
i
Zip �� Telephoned
ENGINEER'S NAME Last (� 5 K� First�� Lic. No.
Engineer's Address (; U ) 2
State �---- �-i I
city
Stt
Fc 1
Engineer's E-mail Address
5�'S I1 nl DZ i� cx
Zip l Telephone,- C,;7gC)
CONTRACTOR'S NAME/COMPANY I ► � J y� ( � � � p c -1 Lic. No. �4 1 Class C j 3;
Contractor's Address
City r% State
SETBACKS REAR 6 SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE -7L3 DEVELOPMENT NO
Contractor's E-mail Address
Zip Q' T(,3 Telephone�l Y V
PERMIT NO. YZo c o - G-JJS
7 PLAN CHECK NO. 137 N - Z-a-�W
PLAN CHECK FEES $