HomeMy WebLinkAboutX2020-0461 - Permit ApplicationI?€IftFo�rYt_ m Worksheet for Combo Building & Solar Permit Application o4?`""°Re
[` Comm'I I i Residential City of Newport Beach - Building Division ytOtO - o 6
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `^
,7,ffuilding r', Grading j—Drainage I—Elec [7 Mech r- Plum Cu YdCut�' CuvdFill
Project Address (Not mailing address) r—, Flood r Fire F-, Liq r! Landslide rN/A Floor Suite No
) °!27 &tkj C01160-,0_ Vd Av,, C -A 6iuz5 1 F
of Work
New/Add SFF—, Remodel SF F— Garage/New/Add
Use F' Const Type
# Storiesv # Units (if Res),
Valuation $
Material/Labor 1y61
600
OWNER'S NAME Last �.✓Yl c)� First __5e K_
Owner's Address Owner's E-mail Address
] 927 rYcdtl e, n`1-wo c
City (- I.rof, .p I n 1,Fil.r. _ State F( Zip 1q
,2(6, *5j Telephone '%/4 (?3/ D -?(o3
APPLICANT'S NAME Last
Applicant's Address
933 A1urty- 194
City C. -..e_ auw, State
First
Applicant's E-mail Address
StCLA�fc5l,�11k4 0/rvr, ccvy
Zip Telephone 9`432-Z,-.3j(r2
ARCHITECT/DESIGNER'S NAME Last First Lic. No. F_
Architect/Designer's Address
City State F_ .
Architect/Designer's E-mail Address
Zip F—. TelephoneF��
------
ENGINEER'SNAME Last First F Lic. No.F_
Engineer's Address
City State
Engineer's E-mail Address
Zip [_ TelephoneF_
CONTRACTOR'S NAME/COMPANY L`- 5�� Lic. No. Class
_Cr6
v
Contractor's Address
City c s� ,, VOA,", L,r, .__. State I CA
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
Contractor's E-mail Address
Zip g2lZ7 Telephone (,08 q6<1-_3933
PERMIT NO. Xtio V •(/
PLAN CHECK NO. 00f A
PLAN CHECK FEES $