HomeMy WebLinkAboutX2020-1403 - Permit ApplicationPLForm;Worksheet for Combo Building & Solar Permit Application O4�6WP0�,6
❑ Comm'I j Residential City of Newport Beach -Building Division ,y2070-� �1 03 q
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❑Building ❑ Grading []Drainage ❑Elec ❑Mech ❑ Plum cu Yd cut Cu Yd Fill
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
Description of Work UseConst Type
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#Stories❑ #Units (if Res)❑
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New/Add SF .Remodel SF Gara a/New/Add Material/Labor
OWNER'S NAME Lastl �r � First byiy-� �,
Owner's Address
Owner's E-mail Address
City t^ State 1 Zip® Telephone��
APPLICANT'S NAME Last t�
VTI I've t (`1 in First
Applicant's Address Applicant's E-mail Address
city �l �y� r fir, 1 State ® Zip f1"r , , �� Telephoned
ARCHITECT/DESIGNER'S NAME Last s— •�� G ✓ 1F�
� —I I First � 71 Lic. No.
Architect/Designer's Address
City State
Architect/Designer's E-mail Address
Zip ��( Telephone q �qq
ENGINEER'S NAME Last�_A k<1K First Lic. No.[—
Engineer's Address (�
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City �an\z_ A _I State ®
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City J State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Engineer's E-mail Address
zs 1
Zip()' Telephone
Lic. No. Class
Contractor's E-mail Address 14
Zip Telephoned;
PERMIT NO. / k
PLAN CHECK NO.
PLAN CHECK FEES $