HomeMy WebLinkAboutX2020-2937 - Permit Application'Worksheet"fdt Combo"EFu`iidin� & Solar Permit Applicatidii
Comm'I r Residential City of Newport Beach - Building Division
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NOTE. PLAN CHECK FEES DUE AT TIME OF SUB IT AL<.aar,P
F -Building F_ Grading F• -Drainage F`Elec FMech f-PlumCu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F Flood r'" Fire F- Liq F_ Landslide CN/A Floor Suite No
Description of Work 3�
Use Const Type F
# Stories? # Units (if Res)P
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Teti-i-al�� `'151?--
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New/Add SF Remodel SF F
Valuation $
I 0 Dov.
Material/Labor � 7
// II,Garage/New/Add
OWNER'S NAME Last �p C� ( C_ (V� 1 t�iMO ASS zG
Owner's Address Owner's E-mail Address
City,- �c,� State c Zip RZilj(p 3 Telephone7v,7)4-7 -6/Q/
APPLICANT'S NAME Last i2E1?EVi: i C �2 First 1 --
Applicant's Address Applicant's E-mail Address
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City Fq�v� Cry_ -e State Zip o G / t_) Z Telephone 4`070-7 p0 v v
ARCHITECT/DESIGNER'S NAME Last First F��'
Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State r-� --�-- Zip F- Telephone ---
ENGINEER'S NAME Last / `�� First (G[L Lic No.;�
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Engineer's Address Engineer's E-mail Address
State Zi hone
Cityp � Tele P
CONTRACTOR'S NAME/COMPANYLic. No. 91 %� �cj Class � "' S
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Contractor's Address Contractor's E-mail Address
city J J� State ZiP d j>� Z Telephone o (U7 &CaZ
SETBACKS REAR SETBACKS FRONT PERMIT NO.6 ,&.4 1
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N0. �Zfyf j �j�u
USE ZONE 4�!%n, DEVELOPMENT NO PLAN CHECK FEES $