HomeMy WebLinkAboutX2020-0380 - Permit Application (2)Print Form ] Worksheet for Combo Building & Solar Permit Application
Comm'IResidential City of Newport Beach - Building Division X Zo
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL /` U w
wilding ❑Grading []Drainage ❑Flet ❑Meth ❑Plum Cu yd cut Cu Yd Filll
Project Address (Not mailing address) ❑ Flood ❑ Fire ❑ Liq ❑ Landslide ❑N/A Floor
Suite No
2_cAP-1��4,LlS�F�i N -no1z7 I +4Gt4
Description of Work Use Const Type F\/ Ma N.
GjJDiL+46E • r FT n" IC , #Stories #Units (if Res)
% % r) ;447-04,1L IJiK
New/Add SF -VQl 8 Remodel
OWNER'S NAME Last
Garage/New/Add
First I )Z)AI 4 7;L%,7'U till '7 . vl Z
Owner's Address Owner's E-mail Address
City -AIF-u��o�T ('qC-N State C, Zip �2�_�a Telephoned
APPLICANT'S NAME Last
Applicant's Address
City I t�'i�v..i_�a�-7'c3� ; 'State L
First
Applicant's E-mail Address
@CJ L1 s �t 7. N,
Zip — Telephone %y?J(5)Y5_
ARCHITECT/DESIGNER'S NAME Last—� First ys�iq y�1 Lic. No. FZ33/
Architect/Designer's Address
City _ni/�p�?ygCyy� State
Architect/Designer's E-mail Address
Zip--Z6�'2 Telephone _2= - 3 ��
ENGINEER'S NAME Last �t l'rZ{_ First#�L __ Lic. No. F Iii
Engineer's Address Engineer's E-mail Address
City _- - �.!'y _- State �� ZIP -92� 0�� Telephone / rf 3 (3� Z% 717
CONTRACTOR'S NAME/COMPANY
Contractor's Address
_. _..--------------.__--
City—� State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip Telephoned
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $