HomeMy WebLinkAboutX2020-1502 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application
F- Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �oaN
()<Building F_ Grading j—Drainage (— Elec F— Mech Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood I— Fire F- Liq F_ Landslide f N/A Floor Suite No
Qks VA9
Use Const Type
Stories #Units (if Res)[
Valuation $
Material/Labor .C.C. ,_
New/Add SF (:::,.g Remodel SF
Garage/New/Add �, o
OWNER'S NAME Last LS
First S?
Owner's Address
Owner's E-mail Address
City�f,q�jJ" State
Zip �L 7�. Telephone5 74% " 43 7::�
PPLICANT'S NAME Last
First
e'
s Address
Applicant's E-mail Address
City Stag
Zip Telephone
ARCHITECT/DESIGNER'S NAME Last sAFNOFIVA N First I�IPD Lic. No. C S051
Architect/Designer's Address
Arch itect/Designer's E-mail Address
f/ S. eroe-sr Alw_.0 # 316
1�C larch j' G7f.S l 9. 4CM
City 4/� i at A ;�k=_/46 State Cj�-
Zip �Z�p�' Telephone d�EJ9' , 7/5 •�• p�
ENGINEER'S NAME Last j`�
First IJAW Lic. No.
Engineer's Address
Engineer's E-mail Address
1.27zO # COI
4C� �n�rrt�Cl`i`nq-5f�v�.
City I 4A&4kAr State
Zip �vd Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. Class F—
Contractor's Address
Contractor's E-mail Address
City State F_
Zip � Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ 1 S% 2. , 6