HomeMy WebLinkAboutX2020-2579 - Permit Application (2)„.Print Form, ; j Workssheet for Combo Building & Solar Permit H
rj Comrri'I_r-)(2020-75 City of Newport Beach -Building Division pj
N TE: PLAN CHECK FEES DUE AT TIME OF SUBMITT `•J
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Project Address (NO mailing address)�F-i Flood r jFire Vii, Liq Vii, Landslide F-iN/A Floor Suite No
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Description of Work U f ,
Use _ I Const Type I
Stories # Units (if Res)n
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Valuation $
Material/Labor JC1
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New/Add SF� Remodel SF arage/New/Add j
OWNER'S NAME LastFirst
--------------------I __--------------------
Owners AAddddrress%� Owner's E-mail Address
city t) -IL- S -1 - - - Telephone
APPLICANT S NAME Last First
Applicant's Address G V Applicant's E-mail Address
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City
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ARCHITECT/DESIGNER'S NAME Last I First J Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
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City � State �—', Zip Telephoner—i
ENGINEER'S NAME Last aM� - First�� Lic. No. l ;l
Engineer's Address Engineer's E-mail Address
City State JJII Zip [7-77777 Telephoned
CONTRACTOR'S NAME/COMPANY Lic. No. —'I ClassF l
Contractor's Address Contractor's E-mail Address
' Telephone -1
City State 7 _ Zip �77
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SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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