HomeMy WebLinkAboutX2020-1514 - Permit ApplicationPrint Foffn Worksheet for Combo Building $ Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division xZ16%U ' 15) L(
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
7 uilding r Grading [—Drainage r Elec r Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not r Flood r Fire r Liq r Landslide f N/A Floor Suite No
/m�ailing/'address)
22�� 60146 Ci Y
Description of Work
Use F—Const Type
2 VV�
# StoriesF # Units (if Res)F_
Valuation $ ,
Material/Labor I(�p
New/Add SFF O Remodel SFF_
Garage/New/Add �—
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OWNER'S NAME Last
Firstr'7 " n /
�1
Owner's Address
Owner's E-mail Address
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City I VU — F6� State I � ZipCV— 6o (o Telephone 7V ,__7,5- , l�
APPLICANT'S NAME Last 1 ��
First rw_
Applicant's Address
Applicant's E-mail Address
City L")� State I l..d
Zip F5 Telephone�SO
ARCHITECT/DESIGNER'S NAME Last
First [_ Lic. No. F—
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
City State
ZipF— Telephone
ENGINEER'S NAME Lastc- First Lic. No.
Gt� S
Engineer's Address
Engineer's E-mail Address
2� —ry , f t/ S77 J
City / e State
Zip Telephone CDD
CONTRACTOR'S NAME/COMPANY �sT Lic. No. gV03" Class GL'
Contractors Address
Contractor's E-mail Address
City. State I 7T
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Zip/ %.(,�� Telephone
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $