HomeMy WebLinkAboutX2020-2477 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o�NEWP°Rm
r Comm'I Residential City of Newport Beach - Building Division X �(��_ �y7% l�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c9pµN�
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Project Address (Not mailing
address) f Flood [_ Fire j— Liq j— Landslide F_N/A Floor Suite No
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Description of Work
Use Const Type F
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122►v D-2L
# Stories #Units (if Res)
Valuation $
New/Add SF �® Remodel SF S t= Garage/New/Add F Material/Labor
OWNER'S NAME Last
III/ First S'eji�ltJ
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Owner's Address
Owner's E-mail Address
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City Cja#,y\A,- by L MA-iZ
State ( zip I '726 2S- Telephone 11(9- 231- SZZ 70_7
APPLICANT'S NAME Last
MA RR, First 1 7-0 rh
Applicant's Address
Applicant's E-mail Address
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City
State Zip 460 Telephone fly^$0.3" ►"�O�
ARCH ITEC``T_/DESIGNER'S NAME
Last First Lic. No.
Architect/Designer's Address
F_
Architect/Designer's E-mail Address
F_
City I
State Zip I Telephone
ENGINEER'S NAME Last
First Lic. No.1
Engineer's Address
Engineer's E-mail Address
City �—
State F— Zip Telephoned
CONTRACTOR'S NAME/COMPANY
fMnMCA,Lic. No. �r'69y'j p Class
Contractor's Address
Contractor's E-mail Address
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City I /J Po Qe
State Zip �a6� d Telephone �� �d� • 9Z acl
SETBACKS REAR - y
SETBACKS FRONT 0 PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT 6 PLAN CHECK NO.
USE ZONE F - I - G 0
DEVELOPMENT NO PLAN CHECK FEES $