HomeMy WebLinkAboutX2020-1333 - Permit Application (2)kXvzo - f333 (a5V Nc�r)
Pdni Form , Worksheet for Combo Building & Solar Permit Application
{1 Comm'I ❑ Residential City of Newport Beach - Building Division .
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
�1Building E] Grading
❑Drainage XElec P�Mech ]Plum cu Ydcut� Cu Fill cut
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq E] Landslide []N/A FIIl00000rrr Suite No
(16VaLomftbIz
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Description of Work
Usedj y� j onstType
A
_
Ohl - 5 ti >t L it l i U� Weal m
# Stories # Units (if Res)
New/Add SF
Remodel SF - Garage/New/Add
Valuation $Materlalor-
OWNER'S NAME
Last I First
Owner's Address
_> _-
Owners E-mail Address
17)e-,
City
State r 67 Zip d Telephone y
APPLICANT'S NAME
Last First ♦Ab
Applicant's Address
Applicant's E-mail Address
City e IC_
- — State `/� Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First G Lic. No.
ArchitecUDesignses Address
_
Architect/Designer's E-mail Address
city - (� �),- — - --J State Zip Ej 66A Telephone
f
ENGINEER'S NAME
Last L—_ First � J1-1
Lic. No.
Englneer's Address
Engineer's E-mail Address
city
J State r Zip � 1 Telephone i
_
CONTRACTOR'S NAME/COMPANY_ bFhLr rY"I ✓° - -_ Lic. No. Class
Contractor's Address
Contractor's E-mail Address
City C— -_ ^ _
_-1 State� Zip F Telephone
7-7
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. �V �•W�
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $