HomeMy WebLinkAboutX2020-2692 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application nntv)�
Comm'I Residential City of Newport Beach - Building Division .Aruj21 . .%q NOTE: PLAN CHECK FFFR NIP ATTWM nC QI IMRAITTAI
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Project Address (Not mailing address) F Flood j— Fire r Liq j— Landslide FN/A Floor Suit
Description of Work — CY��
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New/Add SFG F d �� Valuation 1
/ I_ '� • —� Material/Labor 1
OWNER'S NAME Last First 1
Owners Address
Oy�hlel's E-mail Address
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city O State F7A Zip I—�— Telephone�(�_8� 82
APPLICANT'S NAME Last oU n' i I FFiirs(t i
Applicants Address ° J1 Applicant's E-mail Address
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City I li��l� State �— EV F7 `l —( '�C..
FM v Zip Telephone
ARCHITECTIDESIGNER'S NAME Last First
� rfqp� Lic. No.
FC— /5-
ArchitectlDesigner's Address ArchitecUDesigners E-/mail Address
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City I ���{� State �— Zip i`-i / l'R pit Telephone � q—q8 Z O Z(?i(o
ENGINEER'S NAME 1 Last �I I �First ✓ t�— Lic. No.F—
Engineer's Address Engineer's E-mail Address
City F State I Zip F— TelephoneF—
CONTRACTOR'S NAME/COMPANY 1 Lic. No. F — Classr—
"ontractors Address Contractor's E-mail Address )Ql(
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TEAR SETBACKS FRONT PERMIT NO.
T SETBACKS RIGHT PLAN CHECK NO.
DEVELOPMENT NO PLAN CHECK FEES $
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