HomeMy WebLinkAboutPV2020-114 - Permit Application1pV70?1.0 115 13I!� Cuv�J
. �;,— ormM �e� Worksheet for Combo wilding & Solar Permit Application
F_ Comm'I r/ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
('!wilding [',Grading f—;Drainage r; Elec J—', Mech F_ Plum cu Yd Cut I—
Cu Yd Fill F_
Address (Not ma
F_ Flood f— Fire I—Liq rLandslide
t boo. Cvie.b 6U.�Porl— &z.,cf— Gh 92&6 3
rN/A Floor
Suite No
Description of Work Use F—Const Type
6,, 34-.2 o+�c eJcs vue_ d e,--�e�r-. 3 7 S, B S�j �
- l #Stones #Units (if Res)'
ov , �H. PSP N %es lam, 3iA/,e r
valuations ,ono - 561&r
New/Add SFF—, Remodel SFF— Garage/New/Add F—, Material/Labors Opp
OWNER'S NAME Last
First
Owner's Address Owner's E-mail Address
0 4�a-C�J6a �oJero
City I N't-te)gor-I R cLck _. State F— Zip 12p(p3 Telephone -71[4 Gfe7- `fb76
APPLICANT'S NAME Last
Applicant's Address
C( 3 3 / tAj ka( 5�
City I LAOS.', State F&�
ARCHITECT/DESIGNER'S NAME Last
Architect/Designer's Address
City State
First 151-1 �
Applicant's E-mail Address
Zip _.°laL7._ Telephone ()4 32.G-3/(-2
First Lic. No.
Architect/Designer's E-mail Address
Zip F Telephone
ENGINEER'S NAME Last �o, y� First Lic No. G6a q/(o 3
Engineer's Address
202? L,9ltlt�_C
City H I,. State C�
Engineer's E-mail Address
Zip G12(e cF Z. Telephone
CONTRACTOR'S NAME/COMPANY
Contractor's Address !i rte
ef 3 3 _/ ajkt G/ 5�
City F75 , N Y , State FEW
-
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
Lic. No. Cj 2 y 26 ?Class G�h rb
Contractor's E-mail Address
Zip 9'2( z- Telephone (io8 4$ 9/- 313 3
PERMIT NO. �(&07,0 — l 7 60�
c.�. PLAN CHECK NO.
DEVELOPMENT NO D� 1 q PLAN CHECK FEES $