HomeMy WebLinkAboutX2020-2463 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 0"z_ -°"e
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G4ppwM•
rBuilding F_Grading(Drainage
rElec F_Mech F- Plum CuvdCutr Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire r Liq F- Landslide FN/A Floor Suite No
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Description of Work
Use F' Const Type F
DN 8,A;d:� 9Z3
Ctr*AP-c 9 in* 1-4-75-
# Stories # Units (if Res)F_
6u.d7. ,ca-•
EZr<p�e. -�- �4Nirys.
New/Add SF�—
Remodel SF�— Garage/New/Add
Valuation $ ,
Material/Labor �/ao0
OWNER'S NAME
Last -exi, _ARG140V_)SvIJ First LPlrQ RY
Owner's Address
Owner's E-mail Address
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City I
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State - _
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- _ ZIP `jOo25 Telephone 31D -g} 9Z9a6
APPLICANT'S NAME
Last cflwc�G First S' -M,, I -
Applicant's Address
Applicant's E-mail Address
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City (/� µ�2
bs
State Zip �%Op2T Telephone SID 6, zz
ARCHITECT/DESIGNER'S NAME
Last � First I 'Pp+R,,IL'
rh.�-GAS_ _... _.. Lic. No.
Architect(Designer's Address
Architect/Designer's E-mail Address
jeloo S S.r.o-f r)p;. e 41400 pw �N xm,� tilr�oel Itac . c a 5
City I LA
State I „ Zip F gbo2-n TeleP 3v 82hone 6.21U�
ENGINEER'S NAME
Last v Prtze k First I eil Lic. No.F
Engineer's Address
Engineer's E-mail Address
Coco-+ WAst� �+
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�LYo bqrM.elAe LeJa2t4. .,re-,
J314
City [�,(y�L � f7
State Few Zip 9 -DD Z 32 Telephone %a .Qo9a
CONTRACTOR'S NAME/COMPANY Lic. No. F ClassF
Contractor's Address
Contractor's E-mail Address
City
State I Zip F_ Telephoned
SETBACKS REAR
SETBACKS FRONT PERMIT NO. )C1,0zo— N63
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $