HomeMy WebLinkAboutX2020-3011 - Permit ApplicationPrint Form
Worksheet for Gornroo Building -& Solar POMit Applicati
F_ CommI Residential City of Newport Beach - Building Division on -
PLAN CHECK FEES DUE AT TIME OF Si )PRAITrAl
Q,,: I _J:_
I UfdOing F-Drainage Elec F Mech plum cu Yd cut
Project Address (Not 52 F Cu Yd Fill
mailing a&reSS) F Flood F Fire F Liq F Landslide F_N/A Floor
c) ir,,,s ci,%,e — Suite No
Description of work
Use
Const Type
# StoriesF?— # Units (if Res)r—
New/Add SF �7=_-
emodel SF Garage/New/Add Valuation $
OWNER'S NAME I I I I I - 11!��_ ... !�� Material/Labor
Owner's Address ast dyK-e First fz j
F7r,-,s Owner's E-mail Address
- - - --------- - City
i t yf1 e de� C V1 State Fc_
7 C 0i S-
PPLICANT'S NAME .......... ..................................... Zip Telephonef S578
Applicant's Address Last F(2 First
lv I t Sr I Applicant's E-mail Address
ity
State Fq 27� Zip
ARCHITECT/DESIGNER'S NAME Last Telephone q L4 Q Z I
Architect/Designer's Address First Lic. No.
Architect/Designer's E-mail Address
city State
Zip Fq26 Telephone l (qq 2 2 -ci
ENGINEER'S NAME
Last
1 2 First -T
Engineer's Address Lic. No.F6
-C ave Engineer's E-mail Address
city
ctc State 1--Zip r, Telephone[,j 6 7 - 27
CONTRACTOR'S NAME/COMPANY
Contractor's Address A-P,412- f C-11 1.) Li No
Class
Contractor's E-mail Address
V-10se I I Ir- 6W4��7_ C _45 C 0
City State
Zip 70� Telephone
SETBACKS REAR --------- SETBACKS FRONT
_TBACKS LEFT PERMIT NO.
------- - - . SETBACKS RIGHT
?ONE ---------- _ DEVELOPMENT NO ------ PLAN CHECK NO.
PLAN CHECK FPP.qt