HomeMy WebLinkAboutS2020-0153 - Permit Application (2)Punt Form,; ';I Worksheet for Combo Building & Solar Permit Application
❑ Comm'] ❑ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
❑Building ❑Grading ❑Drainage ❑Flet ❑Meth ❑Plum CuvdCutl Cu Yd Fill[
Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor f Suite No
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Description of Work
New/Add SFF J Remodel SFF
OWNER'S NAME Last
Owner's Address
Use F Const Type n
# StoriesF7# Units (if Res)7
Valuation $
Garage/New/Add j Material/Labor -- -
First
Owner's E-mail Address
City State [7777 Zip Telephoned
APPLICANT'S NAME Last
Applicant's Address
City State
First
Applicant's E-mail Address
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
I
Architect/Designees Address
City State [
ArchitecYDesigner's E-mail Address
Zip �� Telephoned-
---- - - - -' -- -- -- —--
ENGINEER'S NAME Last _ - -- First - - - Lic. No.( _ 'I
Engineer's Address
City �— State
Engineer's E-mail Address
Zip,f—1 Telephoned
RONTRACTOR'SNAME/COMPANY77it SJ t - ca,ea ca0L9-- Lic. No.
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Contractor's Address O ` r Contractor's E- ail Address
-%�-�_�-_ �-✓tine D._I�N.--- �c7 Scc ��
city n — State � Zip (� Telephone �(
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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