HomeMy WebLinkAboutX2020-0729 - Permit Applicationq W nOJ.A
Print Form Worksheet for Combo Building & Solar Permit Application
Comm'I Residential City of Newport Beach - Building Division 1
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL-:•
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Project Address (Not mailing address) ❑ Flood [i Fire F-, Liq E,' Landslide 00 A Floor Suite No
Description of Work
Use Const Type
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if Stories# Units (if Res)
ation ) '; `1 `J'\
Material/Labor
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New/Add 5
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Remodel SF�—.; Garage/New/Add " {
OWNER'S NAME
Last T - ) First
Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME
Last L t a „� �! First
Applicant's Address
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Applicant's E-mail Address
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City _
- - _ State Zip Telephoned—',
ARCHITECT/DESIGNER'S NAME
Last ( First=,
L�_G�Lic. No. It �_\\ J
-1-1
ArchitectIDesigner's Address
Architec Designer's E-mail Add(ess
City I 1 �� J—�;7�
State �i zip Telephone
ENGINEER'S NAME
Last '` Lj�YI First L7(�. % Lid. No. EFhJ� [,
Engineer's Address
1 Engineer's E-mail A ress,- _
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City '•_
_ _ State ZipRIFTelephone
CONTRACTOR'S NAME/COMPANY
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Contractor's Address
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Contractor's E-mail Address 2- 1
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City rd ��,y (.�•�
- State 1Z— Zip Telephone `17�0�
SETBACKS REAR
SETBACKS FRONT PERMIT NO. • V 1 �1
SETBACKS LEFT
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SETBACKS RIGHT PLAN CHECK NO. r6kcaoaul
USE ZONE
DEVELOPMENT NO �./VY�� �'VV PLAN CHECK FEES $