HomeMy WebLinkAboutX2020-0730 - Permit ApplicationW rw&A
Print Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division S
Comm' r Residential _
BAN AN CHECK FEES DU EAT TIME OF SUBMITTAL,: °+`�
[. uilding Grading ..Drainage =Elec E4ech . Plum CuydCut r Cuvdpin
Project Address Not mailing address) [. Flood E Fire ❑ Liq [ Landslide %A Floor Suite No
ption of Work
Use �� Const Type
�/� li
# Storiesp7 # Units (if Res)E
Val
New/Add S Remodel SF Garage/New/Add G __01 M;
OWNER'S NAME Last O/ ( 7/2 / % ( I First
Owner's Address
I I Owner's E-mail Address
77-1
City % 16� E� State G-y j Zip
APPLICANT'S NAME Last
Applicant's Address
City State
Applicant's E-mail Address
Zip F_ Telephoned
ARCHITECT/DESIGNER'S NAME
Last C-jam C4 S i First
Architect/Designer's Address
City /�✓/}�-� StateJ,g—;'
ENGINEER'S NAME Last 1 dY,
Engineer's Address J f
City 111�11i/f fj L — —. -_ State .�
Lic. No..
Architect/Designer's E-mail Address
Zip � � �, Telephone
�:�V/✓G
First Lic. No.
ITS!
Engineer's E-mail Address
Zip „� u � '� Telephone 7F t�!,Tw� b4L G
CONTRACTOR'S NAME/COMPANY Lic No. F— Class F—
Contractor's Address Contractor's E-mail Address
City _ _ - _ _ State Zip 1 Telephone
SETBACKS REAR SETBACKS FRONT PERMIT NO. /\21/ 0 Q�3V
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $