HomeMy WebLinkAboutX2020-1072 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Sal_XComm'I 'Residential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) F_ Flood Fire f-= Liq F_ Landslide F_N/A Floor Suite No
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Valuation $ 7 UP
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OWNER'S NAME Last %,1- /j/I°Z re"? First
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Owner's E-mail "Address
City L.....---�" -rte State f --. Zip F— TelephoneF_.
APPLICANT'S NAME Last 7/`t//A_>e� First �,4 v -
Applicant's Address Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last 12 /QF/i/%��—V Firstl X �% '.. '-"
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Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last First F Lic. Nof---'
Engineer's Address Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY Lic. No. q%azj Class \3
Contractor's Address Contractor's E-mail Address
City State r-_. Zip F_ Telephoner --
SETBACKS REAR SETBACKS FRONT PERMIT NO. O%
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $