HomeMy WebLinkAboutX2020-2004 - Permit Application,1,Triinrt Fore,; Work heet for Combo Building & Solar Permit Application
F7 Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
gjBuilding
j Grading
Address
OEIec [-, Mech F -,i Plum
of Work
Flood F-, Fire J7
� Liq
Cu Yd Cut Cu Yd Fill
F-,' Landslide F�,N/A
New/Add SF F -37 S-7 Remodel Garage/New/AddF-7-
OWNER'S NAME Last FirstFIM V\ -7y(-)
Owners Address
i
City
APPLICANT'S NAME Last
Floor Suite No
Use Const Type
# StoriesFT # Units (if Res)[
Valuation
Material/Labor Pn
V
Owners E-mail Address
StateZip
Applicants Address
City State
ARCHITECT/DESIGNER'S NAME Last
Architect/Designers Address
City State
ENGINEER'S NAME Last
Engineer's Address
City State
First
Applirant's E-mail Address
Zip
Telephone [3n) -
te
First F77--7 Lic. No. F7777
Architect/Designees E-mail Address
__ - ----------- ----_-
Zip F____ I TelephoneF---_-----_,
F_
FirstLic. N
TE S49Z) 0,
Engineers E-mail Address
ZIP F_j Telephone F
CONTRACTOR'S NAME/COMPANY Lic.NoJN_)MD ClassF�
Contractors Address
h
city
State
SETBACKS REAR SETBACKS FRONT
Contractors E-mail Address
ZIP j0!0-,A)q Telephone 5il-ks ) Tnl%
�_,, OMMEARM
LEFT SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO
PLAN CHECK FEES $