HomeMy WebLinkAboutX2020-2836 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
)— Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(X Building )— Grading Drainage Elec r Mech
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Project Address (Not mailing address) r Flood Fire r Liq r and 'de �N/A Floor Suite No
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Description of Work
Use Const Type (/ Q
# Stories # Units (if Res)[
-to (ca. l'E(
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Valuation $ a ',
Material/Labor
q
New/Add SF� Remodel SF 1$ Garage/New/Add F_
OWNER'S NAME Last 6i;_*
First 6 Q •} (uV-
Owner's Address
Owner's E-mail Address
City F State F—
Zip F Telephone ggq.312.1�15
APPLICANTS NAME Last I O,FE +"00
First
Applicant's Address
Applicant's E-mail Address
City F_ State ��
Zip F Telephoned
ARCHITECT/DESIGNER'S NAME 3 1 3
Last �l�/Z First '�L Lic.No.
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
23 ca"P. Pt-�4 , Sir, ISo
GUAcz . 11z t�G�/iI t • c��✓1
City State
Zip _1��� Telephone [&Jd�
ENGINEER'S NAME Last
First -40M A5 Lic.
Engineer's Address
Engineer's E-mail Address
ISI KALVALIS PR.
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City I G05tft- MESA State �—
Zip Fem;--na Telephone lirco5',, 281-04 O
CONTRACTOR'S NAME/COMPANY AL Do) k 0
Cm 5/ /Zu(%7d _DIL Lic. No. JD2 tt2y7 Class
Contractor's Address
Contractor's E-mail Address
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City 'p
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Zip g `7CS Tele)hone yY3�,S7SI.\„
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SETBACKS REAR SETBACKS FRONT
IV
PERMIT NO. 7 0?,b - b
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $