HomeMy WebLinkAboutX2020-2532 - Permit ApplicationPrint Form ; Wor eet for Combo Building & Solar Permit a �� °�
F_ Comm'I Residential
City of Newport Beach Building Division
F_ ,✓NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT LJ� , a
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[Building r7.GradingF-Drainage F_Elec FMech Plum CuvdCut F Cu. vdFill
Project Address (Not mailing address) [ Flood r Fire F Liq F Landslide N A Floor Suite No
Description of Work Use nst Type',
LVEA;
A- p Y - ! # Stories # Units (if Res)F
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Valuation$
New/AddSF� Remodel SF (�i® Garage/New/Addl� Material/La r�
OWNER'S NAME�` A
Last � C � � � %> N _ First
Owners Address Owner's E-mail Address
city
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city iPU-.1�. '�A �,E.1. State Zip z-4 Telephone yl/F75 0 ".s -s
APPLICANTS NAME Last..lii� �� First i �}{¢/�y)
Applicant's AddressApplic -mail Address
City �N J � i - State Zip � L`7 .: Telephone •gjLy 6 31-- Ji 2z
ARCHITECT/DESIGNER'S NAME /Lust First tic. No.
Architect/Designees Address Architect/Designer's E-mail Address
City State F Zip I Telephoner
ENGINEER'S NAME Last l � First ��� Lic. No. _ �"15�f i
Engineer's Address^'} Engineers E-mail
Address
10 303 9 _._�.� L._ "� `�f6 �Li -�.1`l j5�' r✓. cZ6�iv(IY.e lA i6P✓d.
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City t� State 77 Zip i •Telephon r
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CONTRACTOR'S NAME/COMPAN Lic. No. Class
Contractor's Address G�
/ tsv � "Contractor's E-mail Address 71
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City qw1 ' 6 1641,1+ State r ,C� Zip Telephone 7v,� 02-1?1 Z(
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SETBACKS REAR SETBACKS FRONT PERMIT �'�-C.F'
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. I CA 1b Lo P
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $