HomeMy WebLinkAboutX2020-2164 - Permit ApplicationPrint Form Iw
(- Comm'I I- Residential
F -Building (- Grading
for Combo Building & Solar Permit Application
City of Newport Beach - Building Division Y 2V2V 2-J , H
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F Flood r Fire r Liq [_ Landslide rN/A Floor
Suite No
Description of Work Use Fz�ConstType I l r k
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A��� A p 17 NEWS `Dln� # Storiess #Units (if Res)s
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Valuation $ /M
New/AddSFss Remodel SF /Ov3Cp Garage/New/Add— Material/Laborlh',;�
OWNER'S NAME LastFZ1,
Owner's Address
City I__
APPLICANT'S NAME
Applicant's Address
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First (r_�qa/Yq
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Owner's E-mail Address
State Zlp [_ Telephone v� v ee
Last 1 M6 SS Ati 9�, N First I 6112-) CG
Applicant's E-mail Address
State W Zip �— Telephoned
ARCHITECT/DESIGNER'S NAME Last
Lic. No.
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City / State �� Zip �3 T gpbonel - 7 Z,/ 2/
ENGINEER'S NAME Last
First
Engineer's Address Engineer's E-mail Address
city State F_Zip [ TelephoneF
Lic. No.s—
CONTRACTOR'S NAME/COMPANY "7O!�2zs t —� Lic. No. 7; fl� Class
Contractor's Address Contractor's E-mail Address
City I State F_ Zip F_ Telephones
SETBACKS REAR SETBACKS FRONT PERMIT NO. W V,
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. W
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $