HomeMy WebLinkAboutX2020-2788 - Permit ApplicationPrint Fon„ ( Worksheet for Building Combo Permit Application MORD
r Comm'I r Residential City of Newport Beach - Building Division X ` 2/li � NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
Building r7 Grading [—Drainage j-; Elec r Mech r Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) Floor Suite No
Soo
Ntvlgr� bec-_c� (A ov v 00 -- F�:- F
Description of Work
use
�7 �•' F W -w
#StoriesFT #Units(ifRes)F
Valuation t
Material/Lab1700
New/Add SF[ Remodel SFJ Garage/New/Add —'
OWNER'S NAME Last
CG"VtiFirst
Owner's Address
Owner's E-mail Address
CityI i -t 1 or.C. �,eG Ck state -
Zip ��[CJ(�� Telephones i-T.g
APPLICANT'S NAME Last Ali First �ip�
Applicant's Address
Applicant's E-mail Address
City
State C Zip _-- qj-,,q%0 % Telephone Zly, q,, (1
ARCHITECT/DESIGNER'S NAME
Last— First [, C r Lic. No. { 3 WS
Architect/Designers Address
Architect/Designers E-mail Address
City
State �— Zip F— Telephone)
ENGINEER'S NAME Last
First F_ Lic. No.F_'
Engineer's Address
Engineer's E-mail Address
City
State Zip 7— Telephone
CONTRACTOR'S NAME/COMPANY
�J/k fid, 1 �/,1�}��L~ �� (� Lic. Ngo. (D�jj, Class
S� S
- _
Contractors Address
Contractor's E-mail Address
-
City Qic 1
,1 r/
State I tiri Zip GW (i(d Telephone
ENERGY P/C FEE $
FIRE P/C FEES PERMIT NO.�'Z� Z7
GRADING P/C FEE $
PLANNING P/C FEE $ PLAN CHECK NO. 7j(�e/� - 7 Ztf
ELEC/PLUM/MECH P/C FEE $
PLAN CHECK FEE $
DEVELOPMENT #
_ TOTAL FEES PAID S