HomeMy WebLinkAboutX2020-2813 - Permit Application.: Print'Form `) orksheet for Coriftbo Building &Solar Permit Application
Comm'I Residential
City of Newport Beach - Building Divisio �M 2 zu—Z
(y NOTE: PLAN CHECK FEES DUE AT TIME OF SUE3MITTAL
Building 1�( Grading drainage F_ Elec r Mech F- plum Cu Yd Cut l Cu Yd Fill
Project Address (Not mailing
address) f Flood F_ Fire [: Liq r Landslide FWA Floor Suite No
F
Description of Work
Use Const Type FV43
`
# Stories # Units (if Res)
Valuation $
Material/Labor 60 00 o
New/Add SF Remodel SF 1 Garage/New/Add 1—
OWNER'S NAME Last
�,� C First
Owner's Address
Owner's E-mail Address
City
State Zip F Telephonel
APPLICANT'S NAME Last
/j
/7��►'h��GieZ. First _ a.SC.Cf—
Applicant's Address
Applicant's E-mail Address
1 QM W . - /� i ate. _ /J I ��" (, co �
City h �� G�l.¢�(
State F� Zip �zD ,�6 Telephone IS(-170 - W L.1
ARCHITECT/DESIGNER'S NAME
Last N�GU.,p First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State ZipF Telephone
ENGINEER'S NAME Last
y' � "+Oc 11� First j.3 e Lic. No. �
Engineer's Address
Engineer's E-mail Address
_
City h� �S
State CI Zip
h021 Telephone 3
CONTRACTOR'S NAME/COMPANY
( �� A k 1e / c,, _ m, AO kvs Lic. No. G�Z �. Class
(/V C� Tc
Contractor's Address
Contractor's E-mail Address
3 l Sc 1UC.
City State ICE
nc,, lra��T
Zip �2�z A Telephone I�q-56-ss(o
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $ I