HomeMy WebLinkAboutX2020-0982 - Permit Application (2)yum— 001 q 2
Print Form Worksheet for Combo Building & Solar Permit Application
i— Comm'I Residential City of Newport Beach - Building Division o
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c ^"
'Building F_Grading (—••;;Drainage F, Elec rMech F_ Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood I— Fire r Liq F_ Landslide F_N/A Floor Suite No
Description ofWork
Use F_ Const Type
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# Stories ! its (if es
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Li\Itl .4- �Z 1`A(,�, �Llh�"eC. Ci�uzS �ar�,"f'l m/q
Valuation $
New/AddSFF_ RemodelSFF Garage/New/Add y
Material/Labor�!
OWNER'S NAME Last �GN,I,c �� _._. _..... First I (Ole
Owner's Address Owner's E-mail Address
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City Ne,y,P�'a—. (,� I��, State Zip'��'2S Telephone
APPLICANT'S NAME Last 1_�ca✓� : First
Applicant's Address Applicant's E-mail Address
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city
City State C(a-- Zip _. q770> Telephone....
ARCHITECT/DESIGNER'S NAME Last FirstF Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City j State F Zip F Tele hone...
ENGINEER'S NAME Last �- �s� p,' (/t � First I i Lic No.
_ _.
Engineer's Address lam' Engineer's E-mail Address
City State F Zip F_— Telephoned...
CONTRACTOR'S NAME/COMPANY'��Or.Q�ilwAiA�S* ^ Lic. No. I iboq%O Class
Contractor's Address Contractor's E-mail Address
City _ ex,*, �.n.,C _ State 57 Zip ...q 7 7O5- Telephone 71 -72l -?q(4
SETBACKS REAR SETBACKS FRONT PERMIT NO. )(201,0 —00L(5
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Z
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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