HomeMy WebLinkAboutX2020-2454 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_BuildingF_ Grading
rDrainage rElec (—Meth (—Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire F- Liq j- Landslide I -N/A Floor Suite No
15w1 MASA_
,
Description of Work
Use F' Const Type F_
#Stories', #Units (if Res) �
DN S,t IA; 21 ?_E_op c -0_ eo I14.75-
rnV-
(*P� 2 �4
Nl FES.
'
jij006
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New/Add SFI o "
Remodel SF:
Garage/New/Add '
Valuation $
Material/Labor
OWNER'S NAME LastFirst
L R2 eY.
Owner's Address
Owner's E-mail Address
121ti1 W I Lst+
S.c�Q �G
LRaa-p droV�� Acob5 ,a c• ypkq ..C_6.,
CityL� A
State FZZ— Zip r90�62,� Telephone 310-g} 9-i,9'ac
APPLICANT'S NAME
Last i!prflwG�
First S' -M,, e -
Applicant's Address
Applicant's E-mail Address
906
Sp,4nraoa4Q mac/ Atzc: cp�z
City L -C,563
State I +
Zip 90o2S' Telephone 3/D (oZZ -X51
ARCHITECT/DESIGNER'S NAME Last
First-P4;._le. Lic.No. F
Architect/Designer's Address
Architect/Designer'sAddress
/�
iloo - s &4 i 1. m.JQ Td7�..
1E-_mail
Poi lN'i'F,�2 ITQC_.c,-s
City I /A
StateI „
Zip °yp026 Telephone 316 S26. 21vv
ENGINEER'S NAME
Last V Prtze k
First Lit. No.F—
Engineer's Address
Engineer's E-mail Address
City (1,��f7
State �
Zip 40232 Telephone F3jt 31¢.6046
CONTRACTOR'S NAME/COMPANY
Lic. No. r Class[
Contractor's Address
Contractor's E-mail Address
City
State F
Zip F_ Telephone
SETBACKS REAR
SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $