HomeMy WebLinkAboutX2020-0260 - Permit Application (2)Print Form _ Worksheet for Combo Building & Solar Permit Application
F- Comm1 F-- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) Flood r"` Fire F_- Liq Landslide FN/A Floor Suite No
Description of Work
Use ConstType
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# Storied # Units (if Resf
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'Valuation $
Material/Labor l� (Do -2-
New/AddSF Remodel
Garage/New/Add
OWNER'S NAME Last
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Owner's Address
Owner's E-mail Address
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APPLICANT'S NAME Last
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Applicant's Address
Applicant's E-mail Address
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State ZipF $�;ot3: TelephoneF'�[C�720.-5-77-7
ARCHITECT/DESIGNER'S NAME
Last F_ ', FirstF—Lic. No. F_�!
Architect/Designer's Address
Architect/Designer's E-mail Address
City 17
State —'.. Zip Telephone[
ENGINEER'S NAME Last
�� First Lic NoF
Engineer's Address
- .Engineer's E-mail Address
City �� -.-
�' State F_ Zip�� TelephoneF_�, --
CONTRACTOR'S NAME/COMPANYLic.
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Contractor's Address
Contractor's E-mail Address
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City C'(15 _ 3 er,G(,`
State C Zip q0.�(j Telephone 562 ��( r " 7j__7k�
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $