HomeMy WebLinkAboutM2020-0006 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A I'
Comm I F' Residential Cit of Newport pp�krlation �E �e,
/ y p rt Beach -Building Division M2,0 0 p0. �
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Building r ;Grading j—Draina e 5 ^'
9 ❑ Elec ri Mech �i Plum �`'�—
Cu Yd Cw Cu Yd Fill
Project Address (Not mailing address f- Flood
Z ) [- Fire If— Llq r Landslide �N/A Floor
Suite No
Description of Work
1 Use Const Type F_
# Stories # Units (if Res);
New/Add SF
F777y Remodel SF -
Garage Valuation /New/Add ' Mata t,
OWNER'S NAME erial/Labor) Y�
Last G
First ...
Owner's Address--
�� � t Owner's E-mail Address -
city
- - State
__- -_--- p i Telephon
APPLICANT'S NAME Last r 7 � (ef
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vvlV✓ iJ First
Applicant's Address ) (K/' t / ( (
- - - -
4rJ Applicant's E-mail Address
City ��/ G (J `
State /, ,�(j�. ry
l Zip ry� �JTelephone r�r COW
ARCHITECT/DESIGNER'S NAME r
Last> .�
Architect/Desi gner's Address l
Architect/Designer's First��/// " �'`'�------
W__, � dGGtiGn Lic. No. 1
t/Designer's E-mail Address
City
_.--- ---
State Zip Telephoner_� ~
ENGINEER'S NAME yh }
Last V First
Engineer's E-mail Address Lic• No.
r--------
Engineer's Address dl/
City _. C.n�ttt� �j-'`���-�------ _.
l I V I I SST Zip l -
V i ?_ 7 TelephoneiA7jl `I
CONTRACTOR'S NAME/COMPANY / a� Z
Contractor's Address Lic' No. 3qQA('/Y _ Class
Contractor's E-mail Address l VOp
City
- - ... --.. -- State zip `-`" Telephone
I - -
SETBACKS REAR _ SETBACKS FRONT
SETBACKS LEFT PERMITNO.
SETBACKS RIGHT
USE ZONE PLAN CHECK NO.�y
DEVELOPMENT NO
PLAN CHECK FEESS $ $