HomeMy WebLinkAboutX2020-0740 - Permit ApplicationL Print Form W heet for Combo Building & Solar Permit Application
% / City of Newport Beach - Building Division
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Building Grading ainage •'f�,_/Elec � Mech . Plum Cu Yd Cutl Cu Yd Fill
Project Address (Not mailing address) Flood Fire r Liq r Landslide f N/A Floor S it N
Description of Work
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# Sto es110 # Units (if R
Va Gatidn $
terial/Lab 'r
New/Add SF— Remodel SF� Garage/New/Add
OWNER'S NAME Last First / "�1 �• d�
Owner's Address Owner's E-mail Address
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6,14j y: - n t State Ct%\ Zip Cf /,(( Telephone
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APPLICANT'S NAME Last .-k First
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Applicant's Address Applicant's E-mail Address
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city i1 z.�t State l.f\ Zip Telephone u (o l >
ARCHITECT/DESIGNER'S NAME Last �` ry Lic. . No. First 1y o p
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Architect/Designer's Address Architect/Designer's E-mail Address
City �/i�����t,�'. �il� ; �,<t.�� State ZIP (,,)I Telephone (t� . TO 9 • 12gf
ENGINEER'S NAME Last First Lic. No.�
Engineer's Address Engineer's E-mail Address
City State F Zip I Telephone
CONTRACTOR'S NAME/COMPANY L Lic. No. gL/ 77.7 Class
Contractor's Address Contractor's E-mail Address
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City State Zip Q Zj 4-t Telephoner
SETBACKS REA '>°" SETBACKS FRONT PERMIT NO.
SETBACKS LE T SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $