HomeMy WebLinkAboutX2020-2950 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application oFc`s�'m
r Comm'I F_ Residential City of Newport Beach - Building Division p
NOTE: PLAN CHECK FEES DUE AT TIME OF SI IRMiTTAI
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jl_-�flding F_ Grading F-Drainage r Elec F_ Mech r Plum CuvdCut CuYdFill F_
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
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Description of Work
Use F—ConstType 1
# StoriesF_ # Units (if Res)[_
Valuation
Valuation $
New/Add SF�� Remodel SF—Garage/New/Add
Garage/New/Add F_
OWNER'S NAME Last
First l0l�,�
Owner'sAddreesss
7
Owner's E-mail Address
City 56 L,_F Stater Zip (pf� Telephoned`
APPLICANT'S NAME C4 First
Last LW
Applicant's Address
Applicant's E-mail Address
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City .. _ State F —
Zip T)�TI— Telephone ���, ` —cA 3
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ARCHITECT/ IGNER'S NAME Last �— First F Lic. No. �—
rchite signer's Addle
Architect/Designer's E-mail Address
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City State Ll j�
Zip E�i�f-� Telephone `(,�'� -3 —/JZ( o
ENGINEER'S NAME Last �—
First F` Lic. No.F—
Engineer's Address
Engineer's E-mail Address
City [� State F_
Zip — Telephone ��
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CONTRACTOR'S NAME/COMPANY Iz `� c Lic. No. /a) q 5 j Class
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Contractor's Address
Ala
Contractors E-mail Address
City . '1 State � —
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Zip U TelephoneC13
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $