HomeMy WebLinkAboutx2020-0111 - Permit ApplicationPrint Foam Worksheet for Combo Building & Solar Permit Anplication
C City of Newport Beach -Building Division ' `tel@
Comm'I Residential
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Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide N/A Floor Suite No
_2431 -72VAIE 171
Description of Work
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OWNER'S NAME Last /� L!l�� First
Owner's Address Owners E-mail Address -
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CityFA/F/.�" f?%/ ZZ��Cy State Zip. ��0
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APPLICANT'S NAME Last "(ZCI4grx) � First
Applicant's Address Applicant's E-mail Address
City ZJEGrJi���'%_: i�cii State Zip..� Telephone /�4q-2.ZO_661. �
ARCHITECT ESIGNER'S NAM Last j2p�j�/�� First /�/C�/ 2 Lic. No. %ria
Architect/DesigneesAddress Architect/Designer's E-mail Address "
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ENGINEER'S NAME Last �%IOfJ%,� /3.9 /�.� I First ;�.� .5-q /1% Lic No.1 C
Engineer's Address Engineer's E-mail Address -
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CONTRACTOR'S NAME/COMPANY I Lic. No. Class
Contractor's Address Contractor's E-mail Address
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City State L Zip Telephones j.
SETBACKS REAR SETBACKS FRONT PERMIT NO. d
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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