HomeMy WebLinkAboutX2020-1645 - Permit Application (2)_Pint Form
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for Combo Building & Solar Permit Application9-93
City of Newport Beach Building Division zt,,tm - �,,I '
NOTE: PLAN CHECK FEES DUE AT,TIME OF SUBMITTAL
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Building [Grading mage Elec Mech j- Plum ewd's�utCu Yd Fill
Project Address (Not mailing address) F_ Flood i' Fi Liq r Landslide' ' i�N/,A „Floor Suite No
Description of WorkFT
U e' ' Const Type
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# Stories #Units (if Res)
Valuation $
Material/Labor C�:C� CD
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New/Add SFF_— RemodeISF1. a Garage/New/Add
OWNER'S NAME LastFirst '.z
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Owner's Address Owner's E-mail Address
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City nQG Il State FCA ZIP 5Z��( Telephoned
APPLICANT'S NAME Last �— First 31
Applicant's Address Applicant's E-mail Address
City State Zip �— Telephone—
ARCHITECT/DESIGNER'S NAME �
Last r First�, Lic. No
Architect/Designees Address Architect/Designer's E -m il Address
1'(may_. 3'�/i1C I�k% •i
City � y
A.% L� g l'! State I®C Zip 4Y J t z Telephone
ENGINEER'S NAME Last '%. First'
yr Lic. No.
Engineer's Address Engineer's E-mail Address '
City ����, State I ` Zip C7276•-72— Telephone
CONTRACYOR'S NAME/COMPANY Lic. No. r -- Class
Contractor's Address Contractor's E-mail Address
City State F ZIP Telephoned—
SETBACKS REAR SETBACKS FRONT PERMIT NO.�'� 4 " "
SETBACKS F SETBACKS RIGHT PLAN CHECK NO.i
USE ZO IIE � DEVELOPMENT NO
y PLAN CHECK FEES $
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