HomeMy WebLinkAboutX2020-1735 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application �N,
( Comm'I j�Residential City of Newport Beach -Building Division N
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL coo....
Building rGrading F-Drainage F_Elec rMech
F-Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) r- Flood r Fire F- Liq j- Landslidee.'"TWA Floor Suite No
Description of Work
Use FATConstType
Tgyp! GI _ti' I�Z 5 C
# Stories #Units (if Res)
Valuation $
New/Add SF Remodel SF /t Garage/New/Add �/
Material/Labor
OWNER'S NAME Last �k' f
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First
Owner's Address
Owner's E-mail Address
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City a PAr State
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Zip �� J Telephone
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
1,9 iV16 36r-13
AcAe. K.
City FAao vi State
Zip Telephone 'I_jq_&j (o��(e
ARCHITECT/DESIGNER'S NAME astG First F— Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City State
Zip F Telephone f
ENGINEER'S NAME Last C'�
First JI� °5 Lic.No.1 c5 $ 1
Engineer's Address
Engineer's E-mail Address
IZ% &do" D(denb"r)
.cc-, M
City Ived ills State F
Zip 928� Telephone ( N) �31-11400
CONTRACTOR'S NAME/COMPANY / y' /V1M
6
�H �xn�)�ih ; Lic. No. N Class
Contractor's Address
Contractor's E-mail Address
1 I rnn a . CO M
City-- State�Zip I 7ZTe�pl7oue
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 3� �- Z62_0
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $� L1 q
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