HomeMy WebLinkAboutX2020-1334 - Permit ApplicationXa02_0 I3�14 (,2 5V Nc-�D �,.Po r
Print Form orksheet for Combo Building & Solar Permit Application rel�
City of Newport Beach - Building Division
j Comm'I[] Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building ❑ Grading ❑Drainage �{Elec �XMCu Yd Fill ech ,Plum Cucuvdcut111
❑fire [ Lid ❑
*Project Address (Not mailing address) ❑ Flood iLandslide ❑N/A Floor suite No
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Description of Work
New/Add SFF�-�
OWNER'S NAME
Owner's Address y
City
Use /y� tU�onstType[
# StoriesD i #Units (if Res)CI
- _ - -- ---�f Valuation $
�� Garage/New/Add �1 Material/Labor C, A9
Remodel SF .L l� t =l _
Last
APPLICANT'S NAME Last
-I rum
Owner's E-mail Address
State L �r ' Zip [-� Telephone v
r First
Applicant's Address PL
'E-mail Address
ate Zip�j7� Telephone __—
City i 1
A — --RCHITECT/DESIGNER'S NAME Last (� L�/ First Tc L Lic. No.
f= --J ---'
ArchitectlDesigner's E-mail Address
ArchitectlDesigner's Address
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I Stale /�, I Zip i ZV� Telephone L�sr-
f� 1 7
CITY G
_ I
First —� Lic NoF
ENGINEER'S NAME Last I— __ -- ----- —
Engineer's Address Engineer's E-mail Address
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Zip { 'i
i State F-71zip
Telephone --- ---
City --- " -
Ll c. No. Class
CONTRACTOR'S NAME/COMPANY
Contractor's Address
State
City ..- --.i __.-- -...
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE
DEVELOPMENT NO
Contractor's E-mail Address
i
Zip Telephone
PERMIT NO. J
PLAN CHECK NO.
PLAN CHECK FEES $