HomeMy WebLinkAboutX2020-2458 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °zEw°°Rm
F_ Comm'I r Residential City of Newport Beach - Building Division of
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL cu "
[Building [Grading
[Drainage rElec r–Mech [Plum cuvdCut cuvdFill F_ v
Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No
F_ F_
15401 Mf SA VWv4f,
Description of Work
Use F_' Const Type
�J
CW
(ZE*4C LS 4114-7>.
# Stories, # Units (if Res)
New/Add SFr p .
Remodel SF� Garage/New/Add
Valuation$
Material/Labor
OWNER'S NAME LastFirst
.�I�c1�hSvnl LF1¢¢Y
Owner's Address
Owner's E-mail Address
Z 121 W I LSN,
S,+cE¢ i oc� LgQa drop J Acobso.! c• wPF+ay , co K
City I LA,
State FZZ— Zip 9do2s Telephone 316^f-41-&966
APPLICANT'S NAME
Last `{7psDFirst E
Applicant's Address
Applicant's E-mail Address
�loa S t3�e, 07
pw alt. 4oc' s p o�� xtr%�)C./ A zc- c4-2
City I Lbs
State F�;T ZiP 9oo2T Telephone ¢✓/D (o2Z � �LS)
ARCHITECT/DESIGNER'S NAME Last �r,a��� First_P4;.�l� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
19oo s sw, or nrz:-4q +140o pw�N �Cti4aoel krzL.cati
City I LA
State FZZ— Zip gpaTelephone 316 526.2toc
ENGINEER'S NAME
Last v R I A First � Lic. No.—
Engineer's Address
Engineer's E-mail Address
(o�� wp,�,.w; .b...
"S.
Etvo b-iia-elae wo2tt Fb.nl'Exlnff¢ .SCO'!
City "T.
State Zip 940232 Telephone 316 31f -604d
CONTRACTOR'S NAME/COMPANY Lic. No. F_ Class
Contractor's Address
Contractor's E-mail Address
City
State �— Zip F Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.[j — I
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $