HomeMy WebLinkAboutX2020-2656 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application MOW
F Comm'I r- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUF AT TIME nF si iRneiTTei
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F_Building rGrading j-Drainage rElec FMech F- plum CuvdCut C CuvdFill F_
Project Address (Not mailing address) F Flood j— Fire F_ Liq r Landslide I —N/A Floor Suite No
Description of Work ( I Use F- ConstType
CL 1_Cgb l t1 6 �'-'.
#Stories #Units (if Res)C
New/Add SF J �-}-t-Remodel Valuation$,_b
N ra / w/Add Material/Labor
OWNER'S NAME
Last / � / (-�,(\ First
Owner's Address v 7 J Owner's E-mail Address
FT C.L'
City V �`, "Gl oar
State �� ZiP Tt Z� 2 Lj Telephone L
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APPLICANTS NAME
Last cc First
Applicant's Address Applicant's E-mail Address
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City ��� I�, State /rj Zip 7-
city / 7G,
ARCHITECT/DESIGNER'S NAME Last II IIaa '� r First r o / (?�
(fit, � -�L� 4 � �� Lic. No.
Architect/Designer's Address ArchitecttDesignees E-mail Address
Srv' N
City ,r 5,�, 6-)t State r . Zip f q %_ Telephone -
ENGINEER'S
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NAME Last /,c, � First ��� „ � � n„ Lic. No.
Engineer's Address v 1 Engineer's E-mail Address
City State �— Zip F_ Telephone F_
CONTRACTOR'S NAME/COMPANY Lic. No. I ClassC
Contractor's Address Contractor's E-mail Address
State �— Zip �— TelephoneC
SETBACKS REAR SETBACKS FRONT PERMIT NO. Klb0 y2 - j.bS:Q
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. l�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $