HomeMy WebLinkAboutX2020-2018 - Permit ApplicationPrint Formn_; orksheet fpX Combo Building & Solar Permit Application o1,Ag-
j- Comm'I Residential
City of Newport Beach -Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �. oa '
F -Building r_I Grading F'Drainage r Elec r, Mech r Plum Cu Yd CutCu Vd Fill
Project Address (Not mailing address) F Flood F- Fire r Liq F- Landslide FN/A to ite No
Description of Work ,/ /1 p / ✓7� Use F Const Type F
/i �//) #Stories Units (if Res
Valurb
New/Add SF� Remodel SF�� Garage/New/Add Mat
OWNER'S NAME Last Wli :bE7— First
Owner's Address Owner's E-mail Address
WAY
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Y U3L//U` State Zip { Telephone �j�
APPLICANT'S NAME Last /j_E'r First 1CAWP)/
Applicant's Address Applicant's E-mail Address
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City PFIE N State Zip 9 6 Telephone 90-S-,330
ARCHITECT/DESIGNER'S NAME
Last R; �r-
# / FirstFSC8 %'% Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
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City L S" a%� nl State I -
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/I - Zip Y�i'��p Telephone :�/Q
ENGINEER'S NAME Last ' First [_ Lic. Nof'
Engineer's Address Engineer's E-mail Address
City State r Zip F Telephone
CONTRACTOR'S NAME/COMPANY ^ CCA,'_ % 7 Lic. No.FR Class
Contractor's Address Contractor's E-mail Address
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City State I Zip F— Telephonel—
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $