HomeMy WebLinkAboutX2020-2872 - Permit ApplicationPrint For,,, j Worksheet for Combo Building & Solar Permit `Application 001,
pr Comm'I r Residential City of Newport Beach -Building Division ?NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding r Grading F -Drainage _ lec F_ Mech r Plum Cu Yd CutF_ Cu Yd Fill
Project Address (Not mailing
address) F Flood F- Fire F- Liq r Landslide T_N/A Floor Suite No
Description of Work
Use Const Type
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7 L1F1 oWEr f_t
#Stories[ # Units (if Res)[—
es)[—
New/Add SF F— Remodel SF F—Garage/New/Add F—
Valuation $
Valuation$
Material/Labor F, ®
OWNER'S NAME Last
LAnG� _ First �2x_
Owner's Address
Owner's E-mail Address
1 2
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City 0Z;?0(3- Tee 4State <1 Zip F?&57 Telephone—'
APPLICANT'S NAME Last
S`rY es _ First I a k I '15
Applicant's Address
Applicant's E-mail Address
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City __.. _VV1,eC_%Ak'
State CPQ..... Zip 72.59/ Telephone3jbf->%7 Z. 7
ARCHITECT/DESIGNER'S NAME
Last First F_ Lic. No.
Architect/Designees Address
Architect/Designees E-mail Address
City
(—�—
State F_ Zip Telephone
ENGINEER'S NAME Last
First I Lic. NoT-
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip TelephoneF_
CONTRACTOR'SNAME/COMPANY
wer.L i4vr 2Cny Lic. No. Ff62110.3 Class �)®
Contractor's Address
Contractor's E-mail Address
city &h� m6VtiGq
State ��-- Zip 6416 Telephone F-
3to- 31/0_ 6 9
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $