HomeMy WebLinkAboutX2020-2992 - Permit Applicationl Print Form j Worksheet for Combo Building & Solar Permit Application Emwae
F_ Comm'I r Residential City of Newport Beach - Building Division a
NgTE,QyLAN CHECK FEES Db'NT TIME OF SUBMITTAL
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F—Building — Grading F—Drainag-�Ele'', r Mech l Cu Yd Cut Cu Yd Fill
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Project Address (Not mailing a` r Floo ( re Liq Landslide f N/A Floor Suite No
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02`1 florro Via Dr
sc iption of Work
Use ConstType I
# Stories # Units (if Res)-
Valuation $ i
Material
New/Add SF Remodel SF FGarage/New/Add �—
OWNER'SNAME LastFirst
Owner's Address Owner's E-mail Address
City � State �� Zip F— TelephoneF_
PPLICANT'S NAME Last✓ypli t (vC First /yl�L� jar
Applicant's Address Applicant's E-mail Address
3515 iYll /c G'�✓ G)rGIC' /� 110l 6_yizhC%,C( Yi
City State Zip (MS9 Telephone i5l- —kGJ6
ARCHITECT/DESIGNER'S NAME Last �— First F_ Lic. No. F_
Architect/Designer's Address Architect/Designer's E-mail Address
City F— State Zip F_ Telephone F_
ENGINEER'S NAME Last First Lic. No.F
Engineer's Address Engineer's E-mail Address
— —
City �' State F_ Zip F_ Telephone
CONTRACTOR'S NAME/COMPANY �a /� Lic. No. �Y7120 Class %3— C
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Contractor's Address Contractor's E-mail Address
21T TA &j i, C CGY�
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City � ZG�(� State Ca Zip Telephone G _ Z�-6 6/ _5_7
SETBACKS REAR "j'�r0 ETBACKS FRONT Lp PERMIT NO. �ZO • ?./�,��.�
SETBACKS LEFT S r SETBACKS RIGHT PLAN CHECK N0. 2 •
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USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ r� 1