HomeMy WebLinkAboutX2020-0587 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application ��W°°R>
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(— Comm'I jW Residential City of Newport Beach - Building Division k��p — D53 7 ` {.
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL C(�pµ��l
j� Building r Grading
(—Drainage F_ Elec Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Plot bailing address) F_ F_ Fire F_ Liq r' Landslide 1—N/A Floor Suite No
F F
Description of Work
V�
Use Const Type
# Stories # Units (if Res)
Valuation $
New/Add SF�—
Remodel SF Garage/New/Add
Material/Labor
OWNER'S NAME
Last
C-A A\)OC(Ado 4614 6' (�� Lst
Owner's Address
Owner's E-mail Address
City �
State Zip Telephone
APPLICANT'S NAME
Last First
Applicant's Address
Applicant's E-mail Address
City
State F Zip Telephone
ARCHITECT/DESIGNER'S NAME Last F First Lic. No.
Architect/Designer's Address
Arch itect/Designer's E-mail Address
City
State Zip Telephone
ENGINEER'S NAME
Last First Lic. No.�
Engineer's Address
Engineer's E-mail Address
City
� State F_ Zip � Telephone��
CONTRACTOR'S NAME/COMPANY ()j,V\ V- e / 1�ow G Lic. No. Class
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Contractor's Address
Contractor's E-mail Address
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City `��, 1'LJC�G1(/V�- State Zip 1 92-(U(OC TelephonejC(q4� 5&(0,KS2
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. OL/7S
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $