HomeMy WebLinkAboutX2020-1764 - Permit ApplicationPrint Form Worksheet for Combo Building &Sol r pli n 4E
F Comm'I � "esidential City of Newport Beach - Building DI 'si
NOTE: PLAN CHECK FEES DUE AT TIME O M T c„Foa�,.
Building Grading r` rainage j/Elec F/Mech fr/Plum UYdCut� cuvdFill I✓2 JzAs�6
Project Address (Not mailing address) F_ Flood F_ Fire Liq F Landslide F_N/A Floor `` lI Suite No
of Work
I V&u
605FF_:3,I5W Remodel SF
OWNER'S NAME Last I _FA s
C,q-qvh,v4-
2 -Gar
Garage9N 1Add
First I F ryv5
Use Const Type F
# Stories # Units (if Res)r
Valuation $-30
!1/1.,�
Material/Labor / (JC.^�
Owner's Address Owner's E-mail Address
City it :A- b GVl _. State Iv- e; ZipI'li �� Telephone f 66 ,'ZO j
I t
APPLICANT'S NAME Last
Applicant's Address
6-`6'
City > 1 "f) _i�, State
RCHITECT/DESIGNER'S NAME Last I
Architect/Designers Address
te
City e '�/�� j_ State I r y
ENGINEER'S NAME Last
Engineer's Address
City State
First I UU j' 00 M
Applicant's E-mail Address
VI x'01 Ill e,
Zip F, Telephone
First C� (� Y .V.' Lic No.
Architect/Designer's E-mail Address
Zip
't'� vTelephone i ) ���• ry"7,'�
First 4�( Lic.No.Z �,f�i 3
Engi er's E-mail Address
TL
Zip q�'tr) ( Telephonetf "Iecy_,)
CONTRACTOR'S NAME/COMPANY TTTVVV ��` �KJ �Y \ 1ASrt1. A
Lic,,No. D lass
Contractor's Address
Contractor's E-mail Address
City F—
State 6Zip
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Telep l
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT -.
,fir
NSETBACKS RIGHT
PLAN CHECK NO. O --w
USE ZONE '
DEVELOPMENT NO
m
PLAN CHECK FEES $