HomeMy WebLinkAboutX2020-0242 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I F- Residential City of Newport Beach - Building Division q
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building I— Grading (Drainage I- Elec r Mech
(- Plum cuvdCut r CuvdFill
Project Address (Not mailing address) r Flood j Fire F= Liq j- Landslide f N/A Floor Suite No
4(o i I M o2 S�f4
Description of Work
Use ConstType F
# Stories #Units (if Res)
%�o i7J (4 L-co N1 i f i Lt CZ-0 CX- -(LE L L.t `j
Valuation $
New/Add SF S�" Remodel SF Gara a/New/Add
�8 g
Material/Labor
OWNER'S NAME Last �_c LL (`�
First
Owner's Address
Owner's E-mail Address
F. 0, f3r-?< 7,
City State --
Zip 7 Z7,7 Telephon '7(f)3c? 3 p'3 C-�
APPLICANT'S NAME Last
First (-�{ t S
`lAddress
Applicant's Address
Applicant's E-mail
City �-�'JS�f,rt State 161,
Zip Fn -O Telephon (7t+)3c(-303E'3
ARCHITECT/DESIGNER'S NAME Last UQ; ZCj First c J Lic. No. G 1 bf� Q5-
Architect/Designer's Address
Architect/Designer's E-mail Address
252 Z c rlArouF', t5(' P. 5 ` �i✓ Uv
�ti4L-AAcH C,PAc.13iLL- Nil I
City —(Orrl t`( State I �-/-`
Zip Z7 Telephon 714)3 - 3 o30r3
ENGINEER'S NAME Last P,G K'((}2
First Lic. No. 5 l m
Engineer's Address
Engineer's E-mail Address
3l4 �fb 5D. cotNs-f N,
e ,, MMSE, co M
City I LJCt�c,1-+A �i= 3G ' State 4A.
ZipF,2CoS I Telephone( qlj' ) b"74 81
CONTRACTOR'S NAME/COMPANY C G(�_ ZCc Lic. No. F- Class
Contractor's Address
Contractor's E-mail Address 17(,G 00
14
1 — (' C(-k 11iY-61 L s t`trt-T �: 4
City I T72�-i I`i E State z�
Zip FW Telephon '7X 3 3 o 3 03
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
r-�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $