HomeMy WebLinkAboutX2020-0270 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL X O011j) - 0-410 c_Z-,•
j�Building F_ Grading rDrainage F_ Elec F_ Mech r" Plum CuvdCut CuvdFill
Project Address (Not mailing address) r Flood r Fire r Liq i- Landslide FN/A Floor Suite No
Description of Work
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Use � ConstT e
YP V-
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# Stories # Units (if Res)s
Valuation $ 3 L
New/Add SFr-- Remodel SFr Garage/New/Addy—
Material/Labor �o
OWNER'S NAME Last t1, (D L&e First
Owner's Address Owner's E-mail Address
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City A 1�� a��� State Zip ate 1 TelephonerIwvs
APPLICANT'S NAME Last O t_lk�.VkA &A, First � Mj
Applicants Address Applicant's E-mail Address
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City State I Zip Fj�zss 0i Telephone � (I �2
ARCHITECT/DESIGNER'S NAME Last � � First Lic. No. �zql IS
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chitect/Designer's Address ArchitectlDesigners E-mail Address
City State Zip F Telephoner
ENGINEER'S NAME Last ( a' ] .l t F First �V I p Lic. No. G. I
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Engineer's Address Engineer's E-mail Address
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City r�L°�rr+�r� L..A State Zip j � Telephone�I'M Wo
CONTRACTOR'S NAME/COMPANY Lic. No. F_— Classr—
Contractor's Address Contractors E-mail Address
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City State I Zip �— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Oai�-add
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USE ZONE DEVELOPMENT NO �%()I I G U PLAN CHECK FEES $