HomeMy WebLinkAboutX2020-1608 - Permit Application (2)Print Form Worksheet for Combo Building &Solar Permit Application , RWP0. a
r Comm'I Residential City of Newport Beach -Building Division Y+`� I,� o r
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI A v u.oa "
Building r- Grading rDrainage (IxElec rMech JXPIum Cu Yd Cut R6 Cu Yd Fill l o
Project Address (Not mailing address) F_ Flood r Fire j) ,Liq r Landslide rN/A Floor Suite No
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Description of Work
Use Const Type i
# Stories # Units (if Res)
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Valuation$ y' -3cd, PR -` CO
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, Remodel SF 'Z,t mGarage/New/Add
New/Add SFF��1s
Material/Labor r
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OWNER'S NAME Last I MA,- ZV OIJ
First I tit C,1+ Lz
Owner's Address
Owner's E-mail Address
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City I poops t' F g" State
zip `I" L [ Telephone zZ7 P ra72' 93 2,16
APPLICANT'S NAME Last I MAJz-Vt0
First Lk) tLA, CA,) -t
Applicant's Address
Applicant's E-mail Address
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City State ,
Zip ?:L t Telephone , 9,pjs t 0
ARCHITECT SIGN ' NAME Last jt,06a-h4�1 ', First (,t)/i437 Lic. No. F__—'
Architect/Designers
Architect/Designer's E-mail Address
�Address
City � State —e
Zip Telephone
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ENGINEER'S NAME Last K top Or
First I ,I. (4-® Lic. No.F.-------
Engineer's Address
Engineer's E-mail Address
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City6yT—A-4PA State
Zip q2.:�nS_ Telephone"tif,66Z,og-tt>
CONTRACTOR'S NAME/COMPANY I M( n Lic. No. )13 G1�lassF
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Contractor's Address
(r ontractor's E-mail Address
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city State r
Zip �� Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ,4.Z0 (J
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $