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HomeMy WebLinkAboutX2020-1335 - Permit Application (2)k2o2�'-1335Sv l i Print Form Worksheet for Combo Building ik Solar /�Permt Application Comm'l Residential City of Newport Beach -Building Division to NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL'�-�� j Building F7 Grading DrainagexjElec �KMech Plum Cu Yd Cut LLLLLLdsJJJ Cu Yd Fill F7 'Project Address (Not maG,iiliingaddrress) ❑ Flood � Fire �I Liq [] LandsFloor 1 Suite No TF ti. Description of Work I Use pfj l-90nstType f 11 �T J #Storieswil#Units (if Res) Valuation $ New/Add SFRemodel SF _ JR Garage/New/Add Material/Labor OWNER'S NAME Last IL First Owner's Address _ Owner's E-mail Address 17P - city — © t�'!'�7� — State Zip yr 7.i�i�p Telephonemr/•7.,.> .- l��I�f 7j APPLICANT'S NAME Last _� IFirst' _ ti C71� (`�'-� Applicant's Address Applicant's E-mail Address f --C City State�J. zipG t'i�� Telephone ARCHITECT/DESIGNER'S NAME Last v��=Uri _ First la- - _ Lic. No. 1 0s Architect/Designer's Address Architect/Designers E-mail Address i �j�/ JI / 3 p fir} City _L ( ILL]' _.. ._ _. li State -54K � Zip (i(_.V17d Telephone CI `I _Cj !/7 �Ir ENGINEER'S NAME Last I First -- - _ L Lic No. - - ---_l F Engineer's Address Engineer's E-mail Address City � i Slate � J Zip �—il Telephone i CONTRACTOR'SNAME/COMPANY Contractor's Address A✓ Contractors E-mail Address City State Zip Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. IIW� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. V USE ZONE DEVELOPMENT NO PLAN CHECK FEES $