HomeMy WebLinkAboutX2020-2443 - Permit ApplicationForm
.111 j- Residential,
for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
NOTE: PLAN CHECK)I[FAS DUE AT TIME OF SUBMITTAL
r Grading Drainage 3�lec
Project Address (Not mailing add
of Work
PN�c'V
h Cu Yd
F_ Flood Ire;
I -c i eekL Ztis SF / to �ikw, I-( 1-1 �L,4�1` 1 'I j'S
. e4 !Vll,!
New/Add SF F— Remodel SF �2 ,- ,arage/New/Add F_
OWNER'S NAME Last
Owner's Address
_�2 i-ce
City I Tec,.12cT7Te__�(-_ State I vl
APPLICANT'S NAME Last I Cc
Applicant's Address
� y
3&;>7 C-, 714
City L-C, h S 6,a e,,Cj-L --- State c-
First I F'
Owner's E-mail Address
Cu Yd Fill F
j-N/A Floor Suite No
Use K-3 Const Type F-6
It Stories # Units (if Res)[ —
Valuation $ 4/
Material/Labor ( /
Zip ffsJls.�(G Telephone
First
Applicant's E-mail Address
IC.DrlS�G✓GC'.Y�t� �� ,Car"1
Zip Telephone _7
ARCHITECT/DESIGNER'S NAME Last )eS �pF' �(. Lic. No.
Architect/Designer's Address
City lolLC e State
ENGINEER'S NAME Last l ( /2
Engineer's Address
q02—
City / A State
Architect/Designees E-mail Address /
r�jCp�i'�-e/'r15� wGC1/�'I iT �->,�,C9✓'1
Zip I Togo Telephone O/ ` - 5--_5 6
First t`e t-7 Lic. No. 1 1725Z-
Engineer's E-mail Address
Zip ) Telephone 3r/
CONTRACTOR'S NAME/COMPANY Q x E S &e4 (0 y) Lic. No. ��� /7 ClassIU
Contractor's Address
City I 'Fou )(o)i Vo )-e State (A
SETBACKS REAR SETBACKS FRONT
Contractor's E-mail Address
Zip 7) � 7,2 '7 Telephone
PERMIT NO. X N' V "
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
ISE ZONE DEVELOPMENT NO PLAN CHECK FEES $