HomeMy WebLinkAboutX2020-1866 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Lo zo 1r6(0&
FyBuilding F_ Grading F -Drainage [ Elec r Mach F—, Plum Cu Yd Cud Cu Yd Fla
2
ect Address
of Work
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F_ Flood r Fire (— Liq r Landslide rN/A Floor Suite No
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last I 1 O V
First 1_ AM) F -
Use F—', Const Type
# StoriesF_ # Units (if Res)[_
aborl I q, 62-0
Owners Address Owner's E-mail Address
City fiq -GiA 06V- f�C— q4 State FM—Zip r Telephone G%(`�,Cq 6) --
APPLICANTS NAME
Last ��. ��tf CZ(JA i First
Applicant's Address
City �P1 5 J 0'/ State 519_
Applicant's E-mail Address
Zip �'Z(a26 Telephone C9�� _-- _---
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address
City State
ENGINEER'S NAME Last I
Architect/Designer's E-mail Address
Zip Tele hone
First
Engineer's Address Engineer's E-mail Address
City -- State �— Zip Telephone
Lic. No.F—
CONTRACTOR'S NAME/COMPANY I m t , Lic. No. 5' 61 Class
Contractor's Address
City605MA I •' Esi - State
SETBACKS REAR S U SETBACKS FRONT
SETBACKS LEFT f -I— SETBACKS RIGHT
Contractor's E-mail ddress
6)L_( IZIM l J) "C7 `lC'c/Ccs r0(11^'1
Zip ,, Telephon - XLI h / p
PERMIT NO. -'""0 Z"0"77IL�L�' G
PLAN CHECK NO. �)Z?�l ` 1
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $