HomeMy WebLinkAboutX2020-1725 - Permit ApplicationPrint Form
Comm'I
Worksheet for Combo Building & Solar Permit Application
residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding F- Grading F—Drainage ;x1ec gmech x Plum CuvdCut F CuvdFill F
Project Address (Not mailing address) i— Flood
r Fire F— Liq F- Landslide rN/A Floor Suite No
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Description of Work
Use F—ConstType P b
# Stories #Units (if Res)
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Valuation
New/Add SF Remodel SF Gara a/New/Add
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Material/Labor
OWNER'S NAME Last �(�(z(L
First I TI M
Owner's Address
Owner's E-mail Address
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City I �l .Jpc ft asao14 State CA
Zip 'i2�63 Telephone fCt461.29o. 8454
APPLICANTS NAME Last
First CAA b,
Applicants Address
Applicant's E-mail Address
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uldhou9E5 a gr•A`L . tuw%
city e.— State
Zip �Telephone �14 �tj(p,q(oOrj
26�
ARCHITECT/DESIGNER'S NAME Last W �/�/L-.r' First C(ZA bi.r Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
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�dha�ses c� Ma.i L. covet
City u V State
Zip FL'(i_64i Telephone `74 Q 56-`� 60ri
ENGINEER'S NAME Las{ S , WA
First FZAAt,ST{ KtN Lic No. ;7 10
Engineer's Address
Engineer's E-mail Address
I7 ;,TL oIµTARt, AR .
City N_6, State c4
zip q_z_z-S Telephone
CONTRACTOR'S NAM E/COMPANY
Lic. No. F— ClassF_
Contractors Address
Contractor's E-mail Address
City State
Zip �— Telephoned---
SETBACKS REAR SETBACKS FRONT
IN ^ t
PERMIT NO. X1/0 " II y J
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. IS-1 D — %D2o
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $