HomeMy WebLinkAboutX2020-1598 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
�! Comm'I (—'• Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) [— Flood [ Fire ❑ Liq ❑ Landslide ❑N/A Floor Suite No
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Description of Work VSXx,�E Use ConstType i
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# Stories[ # Units (if Res)C
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Valuation $
New/Add SF Remodel SF Garage/New/Add Material/Labor �U �/
OWNER'S NAME Last Lv _. 1 (First
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Owners Address Owner's E-mail Address
City - �� State -�h Zip 7/'�!I/I Telephone '%q%1�- 6
APPLICANT'S NAME Last �� First
Applicant's Address Applicant's E-mail Address
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City t/ �_- State Zip ' �-7 i Telephone 1 � 7-3 -3� a 0
ARCHITECT/DESIGNER'S NAME Last First F Lic. No.
Architect/Designers Address Architect/Designers E-mail Address
City State 7 Zip Telephoned —I
ENGINEER'S NAME Last First—': Lic No.
Engineers Address Engineer's E-mail Address
City State Zip Telephoned
—._- Lic No �` 1=I Class��
CONTRACTOR'S NAME/COMPANY
Contractor's Addreesss� Contractor's E-mail Address
City =LylN1 State r ZiP Z,�CT r_{ Telephone 7/`�ij.7l���
SETBACKS REAR SETBACKS FRONT 11 PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 2 liOW
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $