HomeMy WebLinkAboutX2020-1349 - Permit ApplicationprintFo�m. Worksheet for Combo Building A
Solar Permit Application UVOWOrj-' Comm'I j`Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ,o%
(Building ( Grading
(Drainage [ Elec (-; Meth rl Plum Cu Yd Cur Cu Yd Fill i
Project Address (Not malling address) ; Flood MFire r Liq F- Landslide [N/A Floor Suite No
10 CAs�rEwlr�a
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Description of Work
Use 9•g Const Type �l-b
# StoriesFTZi # Units (if Res)
•TfNak, *5% IIA -(4
kQ 116 5.r, 13Y ftGw5,46 k Pa/lal or ale
I�Kd4?ttl.�. 2ND ��l �Ephrlflb_.. �j41[al4
New/Add SFF-:+ la(, 5.1~
Remodel SF pS1(p pA1fl. 2113 s.f,Garage/New/Add ��
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Valuation $
Material/Labor r
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OWNER'S NAME
Last First TAtkI Al, A40 6409AA
Owner's Address
Owner's E-mail Address
to 0AS-rCu4 A Tend(H
84� a- g
City 1-_ei �l'm-1k
State "` Zip at(.57 Telephone Got NI-3cd4
I'SNAME
APPLICANT"
Last First S'CEJE
Applicant's Address
Applicant's E-mail Address
2 �IACtFC4
_ STC�(C@ STth1DlMCflltEczS.��j
CityALt50 olqo
', State �— Zip (1(O56 Telephone lgq (,77 -93o4
ARCHITECT/DESIGNER'S NAME Last STPodp First $TEdE Lic.No. c-Zav15
S-rAAO A-94h-rEP7a,
IAC .
Architect/Designees Address
ArchitectlDesigner's E-mail Address
2 'I�nclr� e4
_� STeye e 5Tr0 /tnerEdze cls. ��
Cit
City I Awl)
State r �c X1
Zip 265% Telephone (10 Vn I. CA
ENGINEER'S NAME
Last TW+OD S First "azz Lic. No. 3709
Engineer's Address
Engineer's E-mail Address
22l t Mt C 5"50'a -DV_,_IE 5orra A5o ``AA
City �R Itr�E
�I State I ZiP ciQ(D)2 Telephonej-752-od;dl
CONTRACTOR'S NAME/COMPANY Lic. NoT ` Class
Contractor's Address
Contractor's E-mail Address
City
i
State Zip �� Telephoned—�_
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. p1jq ��Jjp LQ
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $