HomeMy WebLinkAboutX2020-0955 - Permit ApplicationI? X2o2o ✓oar
Print Form Worksheet for Combo Building & Solar P r I App Ica I M
[7, Comm'I F7 Residential City of Newport Beach - Building Division
NOTE: LAN CHECK FEES DUE AT TIME OF SUBMITTAL
7__�Building r `tiding 1prainage Elec Zech J Plum Cu Yd cut Cu Yd Fill F7111
Project A dress (Not mailing address) [Flood Fire r Liq [ Landslide!N/A F�loor� Suite No
71
Description of Work Use Const Type
New/Add SF ! l Remodel SF
Garage/New/Add
j I # Stories( ! # Units (if Res) '
i
Valuation $
Material/Labor
OWNER'S NAME
Last ---— - -- --J First - ---- -�
Owner's Address Owner's E-mail Address
i
City State Zip Telephone
APPLICANT'S NAME Lasti First
Applicant's Address Applicant's E-mail Address
City State Zip Telephone
ARCHITECT/DESIGNER'S NAME Last 'First
------ - ----- Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City -- - - - State j Zip �� Telephone
ENGINEER'S NAME Last J First
Lic. No.
Engineer's Address Engineer's E-mail Address
- - -
City Statat e ' Zip �! Telephone i
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City
SETBACKS REAR
SETBACKS LEFT
USE ZONE
State / j Zip
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
- --
Lic. No.
� - � - ;Class - �
-j
Contractor's E-mail Address
r /�Iel
Telephon
PERMIT NO.
PLAN CHECK NO. '
PLAN CHECK FEES $