HomeMy WebLinkAboutX2020-2919 - Permit ApplicationO�jw ruR 9
I Print ForrWorksheet for Combo Building & Solar Permit Application u'
City of Newport Beach - Building Division _E
Comm'I Residential ° "
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
j—Building F_ Grading rDrainage F_ Elec nMech F_ Plum CuvdCut CuYdFill
Project Address (Not mailing address) ❑Flood Fire F_. Liq Landslide ❑N/A Floor Suite No
Description of Work
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME
Owner's Address
City
Use F- Con stType F
# StoriesF_ # Units (if Resf
Valuation $
Material/Labo
Last First
Owner's E-mail Address
State F Zi _ Telephonef
APPLICANT'S NAME Last First _!
Appi;�ant's Address Applicant's E-mail Address
(city
State Zip - Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No. �—
A chitect/Designer's Address Architect/Designer's E-mail Address
City
State �— Zip 7_7 Telephone
s�
ENGINEER'S NAME Last
First r� J Lic. No.l
Engineer's Address Engineer's E-mail Address
I� State ZIP ��I Telephone
City
CONTRACTOR'S NAME/COMPANY
1Z 'n Lic. No. I 41 Class
Ctinfi'aCtcts Address -
Contractor's E-mail Address
i State
Fill
(y Telephone ) 37 �
City C �-�- J Zip / j ! /—
SETBACKS REAR
SETBACKS FRONT PERMIT NO. �WP.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. ^ ��
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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