HomeMy WebLinkAboutX2020-1616 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application Saw
rW Comm'I F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuildincg r -'Grading F -Drainage rElec F_Mech Plum CuvdCut Cu Yd Fill'
Project Address (Not mailing address) F_ Flood r Fir Liq j Landslidj FrIA FID Suite No
1711 LA+�A Pi5t Sup/,
Description of Work *ARP ,0
�.1- ,,f' Q / Use Const Type
G
I E04 AS7P �s � # StoriesT # Units (if Res)7
IPPIF1a2 �Ma G I-Oer`��E AGS ;:sou U.w YS
�7 s Valuation $
New/Add SFr7T�/li Remodel SF bQ Garage/New/Add Material/Labor � /�14jjlo
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OWNER'S NAME Last �M �411� First V f11
Owner's Address Owner's E-mail Address f
17`lIRAZA- bFt S14/R
City . N " State F jT Zip Telephoners -6 -'.113,6
APPLICANT'S NAME Last 1 First (�
Applicant's Address Applicant's E-mail Address
City State F_ Zip �-..---...-....',.. Telephone[—
ARCHITECT/DESIGNER'S NAME Last G First r- ,`%
� Lic. No.
ArchitectlDesigner's Address Architect/Designer's E-mail Address
City State Zip i /d ; l/ 5 Telephone7/ 0 ^a %73
ENGINEER'S NAME Last fZ?FS First � Lic. No. C o 67
Engineer's Address I ," Engineer's E-mail Address ✓
107S7, UNIT '$'_ a e6) e C,corn
City I J�A AAJA State a�FZip Telephone 5�
CONTRACTOR'SNAME/COMPAN �t� Ccov�,7- IAJC Lic No.Class
Contractor's Address �•1 Contractor's E-mail Address
/Coq`t S- R C t2 _ j2f3tlA2_CdPvZ0U(,*F0/() C1 Alf W -CcM
city-NAHij1A State C k aZip -i TelephoneVL1_?q `6W
SETBACKS REAR SETBACKS FRONT 1 PERMIT
SKS LEFT SETBACKS RIGHT PLAN CHECK NO.
INE DEVELOPMENT NO PLAN CHECK FEES $
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