HomeMy WebLinkAboutM2020-0060 - Permit Application (2)Worksheet for Combo Building & Solar Permit Application ���s Pq,
I Comm'I ruesidential City of Newport Beach - Building Division a
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL a,."
F -Building F- Grading F -Drainage F-Elec F-Mech F-PlumCu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood F° Fir iq j- Landslide F_N/A Floor Suite No
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F3 2 it E al to et, Bii.a C,
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Description of Work -
use ConstTypeF—
re.Pif.rm -L i2.°°
i pile
# Units (if Res)r
New/AddSFF - RemodelSF[—
ddrl
Garage/New/Add ' !
Valuation$
Material/labor
OWNER'S NAME Last g g
Firstf f�
Owner's Address
Owners E-mail Address
134 �. b.�,iizNpeL. ISP Jdj
City RE-C-�J'' eA 3.•2.LiClra State ...Zip C_'�-feG3r Telephonery
APPLICANT'S NAME Last LQ I3 ea%_1
First -[-'c)dvN
Applicant's Address
Applicant's E-mail Address
132 �F_; RaAbe at Bid
a LIA ;Au 0 Acckj�_4 4 c a,�
city I Vim'..' l�yr""4 �i'_[,�C61 State I
Zip C.j-2 Telephone o11y �S"/1
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ARCHITECT/DESIGNER'S NAME Last LL
•
First �gf 1acLic. No. F-3Ii
ArchitectIDesigner's Address -
Architect(Designer's E-mail Address
29� i".3 r'-C�•-mor �,.. ' �-� _ ,.
City `�`C e .Rresi ..State F� .
p^�
Zip l�- G.t,'�� Telephonel. �'`f Gt'ZC''I
ENGINEER'S NAME Last r
First Lic. No.F53 il-Z
Engineer's Address
Engineer's E-mail Address
city L zot_� j 6^cr, State I,_-
Zip FgZ30 Telephone cits�_- e �� q qZi
CONTRACTOR'S NAME/COMPANY gg � � _ Lic. No. Class
Contractor's Address
Contractor's E-mail Address
3-) C O0
r 3 NeAl Mat, el- �% Sbc " Ioba-l• tv4
city �i7 9 State r
Zip �{ 2 Telephone4i 5,t �
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $