HomeMy WebLinkAboutX2020-0095 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division z
F"' Comm'I 7 Residential ;P ), t )b
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL r
1—(Building r Grading F-Drainage F_ Elec j— Mech j— Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) I— Flood f Fire r Liq r Landslide r"N/A Floor I Suite No
�055 VIS-�q (joY11"�q I f
Description of Work Use F—Const Type F—
m 1 r t d 2 oti,al a ►-tic)n new doors Qnd winciows.-#Stories #Units(ifRes)
n100Lj�
ne w 30" wn1
Valuation
New/Add SF � �� Remodel SF Garage/New/Add �� Material/Labor C/lJ
OWNER'S NAME Last Rr1� 0 5 h First I Lo v
Owner's Address Owner's E-mail Address
465 Vt5tq Gon%+-ct
City State CPr Zip gzutoo Telephone 9.49-378-oio11
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State F_ Zip Telephone
ARCHITECT/DESIGNER'S NAME CI'1C 4 5
Last rso r1 First �r t n Lic. No. 37,E
Architect/Designees Address Architect/Designer's E-mail Address
C2n-1r-rcL j Ave. �_ r l rl I C YV A r c 1'l i i e cI S. n e-l-
City Seal &eciGh State FCA Zip 9U7Q o Telephone 5(-2-;g lo' 0195
ENGINEER'S NAME Last l t First Lic. No.
Engineer's Address Engineer's E-mail Address
City I State I Zip Telephoned
CONTRACTOR'S NAME/COMPANY = Lic. No.�6 Class
lP _ � F
Contractor's Address Contractor's E-mail Address
City State Zip Telephone
SETBACKS REAR SETBACKS FRONT ( f PERMIT NO. X
SETBACKS LEFT SETBACKS RIGHT PLAN C AECK NO. �J,
USE ZONE I DEVELOPMENT NO PLAN ( =CK FEES $