HomeMy WebLinkAboutX2020-0285 - Permit ApplicationP�i�t Form Worksheet for Combo Building & Solar Permit Application 0:_
Comm'I �j Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building ❑Grading
FlDrainage aElec FaVtech F,hPlum cuYdCut l CuYdFill l
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Project Address (Not mailing address) ❑ Flood [j Fire ❑ Liq Fj Landslide DN/A Floor Suite No
Description of Work
Use ConstType CI
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# Stories # Units (if Res)
Z I
Valuation $
Material/Labor =0�__
New/Add SFF7:__1
Of li
Remodel SF Garage/New/Add
OWNER'S NAME
Last Last �{E�4i2i1'P�t/y-t First
Owner's Address
Owner's E-mail Address
City I State rs Zip Z[✓2f� Telephone
APPLICANT'S NAME
Last I First
Applicant's Address
Applicant's E-mail Address
C�;c;o c
City
�II�----!
State Zip I� Telephoned
ARCHITECT/DESIGNER'S NAME Last LAA00k First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
I
State �� Zip , Telephoned
ENGINEER'S NAME
Last First —I; Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City _
_ _ State I Zip Telephoned
CONTRACTOR'S NAME/COMPANY
Lic No. Class
Contractor's Address
Contractor's E-mail Address
City _ _
_ _ State ' Zip Telephoned'
SETBACKS REAR
SETBACKS FRONT PERMIT NO. AVM
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 0.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $