HomeMy WebLinkAboutX2020-0427 - Permit Application'`.Print Form Worksheet for Combo Building & Solar Permit Application (9,4-253r Comm'I ential . City of Newport Beach -Building Division K�'t7.0417
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project /Address (Not mailing address) r Flood -Fire F- Liq r- Landslide rN/A Floor Suite No
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Description of Work W.1?zmoVa- 6XISI-r 1tq CoizNE►Z OAIIUMC-NT-
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Valuation
bor 415,000
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OWNER'SNAME-MG lfVfti& COMPA-A"l- QPAIPY-T' -Bizi \l Fee4lvg
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME Last qyG y-t?F31�--TRU IC K INC.
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Applicant's Address Applicant's E-mail Address
1'731 N0 IMfl- 4 s'Tf6G-T aAV,6-0 aa3 Z)
City E7]Z/j-/�i1�'_ State Zip �zgrQ TelephoneF(°%/�f�.2.3�-.8.293
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address Architect/Designer's E-mail Address
State (2 Zip I Zt &O Telephoned '
City 1645ppxqf.
may^
ENGINEER'S NAME 161141 0 4CU>b Lic. No. tr5R0.Z,Z
Engineer's Address Engineer's E-mail Address
Ra, Box Sozo50
City 6A#JTf) C(Ag i Tfl State FE4 Zip . q f 380 'j Telephone G! f 93 _ '760
CONTRACTOR'S NAME/COMPANY E� �K 1N C $D Lic. No. %26 5 3, Class O C
Contractor's Address Contractor's E-mail Address
731 NoMA-1u PEt7— c{AUG �J�3 a,Coa+�l
City oP_AAq (...State �' Zip qZ�b�. Telephone &/* q 3
FRONT NO.
SETBACKS REAR SETBACKS PERMIT
,$ TBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
S ZONE DEVELOPMENT NO PLAN CHECK FEES $