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HomeMy WebLinkAboutX2020-2346 - Permit Application_ 1 W -rksheet for Combo Building & Solar Permit Application cgvwpqi-v�Print Form City of Newport Beach - Building DivisionComm'I ( Residentia 1 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building j- Grading Drainage11ec Mechypium cuvdcut� Cu Fill v Project Address (Not mailing address) F_ Flood rFire F_ Liq j— Landslide N/A Floor Suite No Description of Work Use / )(Qnst Type �(�l/i7/C)ii/ ���J� ) _ /i; C,li / r! S Q�� rrJ� �✓ # Stories# Units (if Re Valuation $ New/Add SF Remodel SF a� S Garage/New/Add F— Material/Labor OWNER'S NAME Last �� First /j ✓,mac l �/ Owner's Address Owner's E-mail Address u 7V -7 .0z/Jlg City F_,�7//_State I Zip Telephone - _E Cif. I z a Ll 9I y— z 7S— APPLICANT'S NAME Last CJL�jP t'1 First "C_ Applicant's Address Applicant's E-mail Address City State �® Zip ;� de 6) Telephone ARCHITECT/DESIGNER'S NAME Last v� First7��, Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address / 17Y6y Cam/ City -v,� •,��, State G�— Zip Telephone C��� �_ S� vz / 77 ENGINEER'S NAME Last ��US 2 G F��irstF� ,;3 Lic. No. E� j }— Engineer's Address Engineer's E-mail Address City .�`v.I r State1�1 Zip C. �v Telephone 9vjr/._'S,S� �j%C (( CONTRACTOR'S NAME/COMPANY Lic No. S�jG%� ? Class Contractor's Address Contractor's E-mail Address y { City State Zip F_ Telephones SETBACKS REAR L/ SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $` r J