HomeMy WebLinkAboutX2020-1230 - Permit Application (2)'\� `1/M/10 � 2- 3 D
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'IResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project] Address (Not mailing address) I_ Flood f- Fire F- Liq F Landslide F_N/A Floor Suite No
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Description of Work
Use �' Const Type
L4
# StoriesF # Units (if Res)
New/Add SFJ Remodel SF 7. ' Garage/New/Add
Valuation 5
Material/Lab( 0. 00 C
OWNER'S NAME Last
First \\
' Owner's Address
Owner's E-mail Address
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State Zip F "?Z :'-� Telephone c
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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city La:,.�.:. �1 t"�r� �
State [--(I_
;'Y Zi g ' Tele hone
ARCHITECT/DESIGNER'S NAME
Last First Lic. No.
Architect/Designer's Address
- Architect/Designer's E-mail. Address
City _. ..
State—: Zip �Telephone
.
ENGINEER'S NAME Last
Ab,2 . -t First Li . No.
_
Engineer's Address
Engineer's E-mail Address
City
State Zip TelephoneF—
CONTRACTOR'S NAME/COMPANY'...
Lic No Jw_"�''= Class'
Contractor's Address
Contractor's E-mail Address
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City f
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State �— zipF33 "`% _ ` f
i.. >I} L ,a Telephone z
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SETBACKS REAR/fs-
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. tr"j�j •- 6
USE ZONE
DEVELOPMENT NO - fDL['C)L--"a PLAN CHECK FEES $
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