HomeMy WebLinkAboutX2020-0739 - Permit Application (3)Print Form Worksheet for Combo Building &Solar Permit Application g��"
[- comm"j' Residential City of Newport Beach - Building Division a =
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °<�Po•+"
Building [- Grading [—Drainage [- Elec [- Mech r- Plum CuvdcutF— CuvdFill F_
Project Address (Not mailing address) [- Flood [- Fire [- Liq [- Landslide [-N/A Floor Suite No
MAID27b,46
Description of Work
Use F Const Type F
# Stories #Units (if Res)
ODi `��c ic_ o:,.t l �S
Valuation $ ��
Material/Labor t �
New/Add SF� Remodel SF Garage/New/Add F—
OWNER'S NAME Last 6UPTA First W
Owner's Address Owners E-mail Address
k1 n S;To ! fz
City I eje'!{ctj State F_CV—_ Zip TelephoneFcr�—
APPLICANTS NAME Last First i GC IL
Applicant's Address Applicant's E-mail Address
�zsa-
City ® f S 1 State I V T Zip l�ilG3� Telephone � 3 6
ARCHITECT/DESIGNER'S NAME Last j� V l I LA— First 1 7 Aiz, Lic. No. (P
ArchitecUDesigners Address Architect/Designees E-mail Address
30 _S CC C.FH WO 2�� g-'�F
/ p
City � Ci�G" F State I ( Zip 9lzG72 Telephone
5-1 -
ENGINEER'S NAME Last V v AUt CL.' First try _TT- Lic. NoF
Engineers Address Engineers E-mail Address
22`Io(o /ksP 'DT
4
City LAu_,tE, GI�� State � Zip (`� Telephone T !q • l 5f / p t� i_f
(C
CONTRACTOR'S NAME/COMPANY r2 U (�� S J Lic. No. F_— Class
V
Contractors Address Contractor's E-mail Address
City t ,064 l 1. State I `ram— Zip I Z&?- Telephone /(t�a
(X
SETBACKS REAR I �) SETBACKS FRONT /C� PERMIT NO. L ° I o % ? l
SETBACKS LEFT S SETBACKS RIGHT S PLAN CHECK NO.OSS
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $