HomeMy WebLinkAboutX2020-2862 - Permit Application�Pri orm �' Worksheet for Combo Building & Solar Permit Application �jEWbg9
City of Newport Beach - Building Division
Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding j— Grading
rDrainage I—Elec j Mech r Plum CuYdCut F CuYdFill
Project Address (Not mailing address) F_ Flood FiFi're'j— LiLiq f== Landslide rN/A Floor Suite No
Description of Work
Const Type
itStori s7 # Units (if Res)[ —
AMg
Valuation $ F
Material/Labor
New/Add SF
Remodel SF� ---Garage/New/Add
OWNER'S NAME
'y�, oy� ,! ^ ��-� �--,—, Last 1'J��QU lt.Q"l L�t�
Owner's Address
Owners E-mail Address
City
State F Zip I_ TelephoneF_
APPLICANT'S NAME
Last I — First
Applicant's Address
Applicant's E-mail Address
City �
State I_ Zip F Telephoned
ARCHITECT/DESIGNER'S NAME Last � First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City �—
State F_ Zip I TelephoneF_
ENGINEER'S NAME
Last First F_ Lic. No.
Engineer's Address
Engineer's 1-4 t`/^J,
City
State F_ Zip F_ TelephoneF_
CONTRACTOR'S E/COMPA Y ,, t r Lic. No. `i3Z
F`�%{r1C CP,�I'S �QEi �� �.e.V10E� Ill, 60() class
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Contractor's Address �)
Contractor's E-mail Address
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City 6� -ZC)3-
SpN
State Zip �a5 Telephone ly`j - 205`f
REAR
SETBACKS FRONT PERMIT NO,
JSETBACKS
S LEFT
SETBACKS RIGHT PLAN CHECK NO.E
DEVELOPMENT NO PLAN CHECK FEES $