HomeMy WebLinkAboutX2020-2863 - Permit ApplicationPrint Form
{�.Comm'I r
Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division )00,20 -563
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading j—Drainageec j—Mech r Plum cuvdcut� CuvdrlllF
Project Address (Not mailing address) F_ Flood r Fire r Liq r— Landslide rN/A Floor Suite No
AolU 91�1) M/&Y<(_ 0Q, A/gu/POaT.6Eae14. ea. 9a(.roo
Description of Work
Use F Const Type F
Auo e/d�F_6 sl
# Stories #Units (if Res)
/
\
(C r /
New/Add SFr— Remodel SFF— Garage/New/Add
Valuation $
Material/Labor'
OWNER'S NAME Last Q[$ryJ First
Owner's Address Owner's E-mail Address
City NLwi�o¢i 9EACH state �q Zip %al l�0 Telephone 9y9 yap
APPLICANT'S NAME Last 10"617Dse First py,Qej /,Ua4r961 6
Applicant's Address Applicant's E-mail Address
o)Iogo iM�r21`� Avr— �cc6re�%qj t,.}�n�Ic� l'oGdr'4 neer; L°O
Citym021<'�Nn VAIISY State Tia Zip gas -S5 Telephone 95/_aya-038f ;
ARCHITEc�yneSIGNER'S NAME Last F— First Lic. No. F_
Architect/Designers Address Architect/Designers E-mail Address
City Iu State F Zip r Telephoner—
ENGItu"'S NAME Last First [_ Lic. No.r—
Engineer's Address Engineers E-mail Address
City State F Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY JABS G �y n�G AOL16 5i �W-S Lic. No. (o L! i cI1 � Class C IO WC"
Contractor's Address Contractors E-mail Address
O dox 9/3/ ga6r�€t�jl 1 n5 l 40road;runner' , coM
b
City f�'JD2 ��0.�0 \� A I I F Y State C/`/ Zip JJ 75aF Telephone qs/ -a o.38Fr
.G�
SETBACKS REAR SETBACKS FRONT PERMIT NO. INC?O�V- rl
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2a& a
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
S