HomeMy WebLinkAboutX2020-1906 - Permit Applicationx wix Aou
Print Form " " Worksheet for Combo Building & Solar Permit Application
C Comm"hZ Residential City of Newport Beach - Building Division o
7 � NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading r,Drainage f-, Elec rMech F- Plum Cu Yd cut Cu Yd Fill
Project Address (Not mailing address) F Flood j` Fire F- Liq - Landslide F_N/A Floor Suite No
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De ription of Work
Use Const Type
# StoriesF_ # Units (if Res)F—
G1_IN
Valuations
New/Add SF��Remodel SF� Gara a/New/Add l
9
Material/Labor Fir;
OWNER'S NAME Last 4'jVC; Qfc_
First .4oe
Owner's Address (7
Owner's E-mail Address
City /VCG State
Zip a�, Telephone �/5-
APPLICANT'S NAME Last n.�n 1 _-..
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._... First -3/;,j
Applicant's Address
Applicant's E-mail Address
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City N /(� State
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Zi � Telephone ,� -3�, .3
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ARCHITECT/DESIGNER'S NAME Last C'l ,PN
,��, First_7c, __..1 Lic.No. 733IF .._
Architect/Designer's Address
Architect/Designer's E-mail Address
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City /Ve. '(%�N ... ei� .... -'i State f - -'
ZiP C%, Telephone "j�V7 6 0 -4 of� _.
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ENGINEER'S NAME Last <�Q&%
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First Cj9I, Lic. No.C 73
Engineer's Address
Engineer's E-mail Address
r 7c) 7 o s
City State -
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Zip U Telephone
466_ 3/0-6I7-509d�
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WNaRoCsOdeNAME/COMPANY
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-Class,
- ic. No. ClasSPN
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Contr
3 TO c X33
E-mail Address
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City State
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Zip Teleph(oVone
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. B
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $