HomeMy WebLinkAboutX2020-2594 - Permit ApplicationI_ _ Print Form j Worksheet for Combo Building & Solar Permit Application o�EW oRe
r Comm'I F Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SI IRMITTAI
(Building Grading j-Drainage F Elec r Mech F_ Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing address) F_ Flood r Fire j- Liq r Landslide rN/A Floor Suite No
Description of Work
---
Use F ConstType F_
�L.�;.:nC.`Y E�� `.J �C CMG �'% d'7�; c`(L /�L'���5
✓ ��i/Cl f�
# StoriesIT # Units (if Res)[_
Valuation $
Material/Labor 77,---,c-, -
New/AddSFF— Remodel SFF ---
Garage/New/AddF
OWNER'S NAME Last ��/�/� S��
First
Owner's Address
Owner's E-mail Address
CitytV State Zip %;C�� Telephone Sy ,_
APPLICANT'S NAME Last P 45.
First
Applicant's Address
Applicant's E-mail Address
% L' (/2 /1
7(( 7��T
City F6C75-, ./ State �.
Zip[�' Tele hone T(Y - C1� P 3
ARCHITECT/DESIGNER'S NAME Last
First
Lic. No. F_--
Architect/Designer's Address
Architect/Designer's E-mail Address
City F State F
Zip I Telephoned
ENGINEER'S NAME Last �C- �/fc`itlQ
First Lic. No. L
/%G,�� C�
Engineer's Address
Engineer's E-mail Address
/
City �� �� State
Zip Telephone 7/r(- T?T5,T2
CONTRACTOR'S NAME/COMPANY
2r N- [S/G% y
�2 ST z� cric Lic No. 77)kl ClassF;
Contractor's Address
Contractor's E-mail Address
77 (ti- 7 C> C -%
c�2�� /��crsrc,vca�✓srzvc,-i��-c E
City CZ57j State y
Zip (f,�L )7 Telephone `%yQ-� ),-,:15-73(I
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
1/O PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
II
v,PLAN CHECK FEES $