HomeMy WebLinkAboutX2020-2479 - Permit Application,<<PnFlt`Forfm ` "11Vorksheet fbr'Combo Btailding &Solar Permit Appficatiori ,E
r Comm'I F, Residential City of Newport Beach - Building Division X/) Q�%fL�(�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI `V �� l
❑Building r Grading ❑Drainage ❑ Elec [ Mech F-, Plum Cuydcuts Cu yd Fill
Project Address (Not mailing address) ❑Flood ❑Fire ❑ Liq �j Landslide ❑N/A Floor Suite No
Description of Work Use Const Type
# Stories # Units (if Res)s
Valuation $
New/AddSFRemodel SF Garage/New/Add- Material/Labor
OWNER'S NAME Last First LLL
Owner's Address Owner's E-mail Address
City - - --- -I State �— Zip F_ Telephoner ---- -
APPLICANTS NAME Last First
------------------- ---- ---------------
Applicant's Address Applicant's E-mail Address
- - -- --
-------- -- - - -
City State Zips Telephone—
ARCHITECT/DESIGNER'S NAME Last - First I - ----- Lic. No. F—
Architect/Designer's Address ArchitecUDesigner's E-mail Address
City State �— Zip F Telephone
ENGINEER'S NAME Last �- First F7777 Lic. No.�—
Engineer's Address Engineer's E-mail Address
- - --
City �- State F- Zip F Telephone
CONTRACTOR'S NAME/COMPANY / r - rt 106 - - Lic.�R �� lass �f� �5
Contractor's Address Contractor's E-mail Address
City State Zi Telaphone
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $