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HomeMy WebLinkAboutN2020-0661 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application F Comm'I r Residential City of Newport Beach - Building Division o NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F—Building i- Grading F—Drainage [_ Elec j—Mech F- Plum Cu vd Cut Cu Yd Fill F Project Address (Not mailing address) r Flood [_ Fire [_ Liq r Landslide F_N/A Floor Suite No Description of Work Use Const Type # Stories[— # Units (if Res)[ — New/Add SFF Valuation $ Remodel SF1__ Garage/New/Add F-- Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Address City State �� Zip F— Telephoned APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City � State F_ Zip F— Telephoned ARCHITECT/DESIGNER'S NAME Last First F Lic. No. Architect/Designer's Address ArchitectlDesigner's E-mail Address City I State F_ Zip [— Telephoned ENGINEER'S NAME Last First F_ Lic. No.F_ Engineer's Address Engineer's E-mail Address City State F_— Zip [_ Telephone[ — CONTRACTOR'S NAME/COMPANY ✓� // // Lic. No. l�ZS�I/ Class /�' LOn�GitsI �C. Contractor's Address Contractor's E-mail Address City �r G. State C/1 Zip Telephon 715 y/W f S/ SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 1>8013 - 2b 11IN USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ rT i Division or s eet for Fire Permit Application o� Pri t Form City of Newport Beach-%Buii d Please print 3copies V �" r���L}C, Associated Building Permit # I 21yo . 40le Fire Sprinkler Fire Alarm %Fire Misc 1. Project Address (Not mailing address) Floor Suite No 2638 Sw„ )au4vs n I,biIII 7,d GA `lasso F_ �— Tenant Name F #Units �- 2. Description of Work oc�ir�n op Use J Extg Sq Ft FNew/Added Sq Ft �— Total Sq Ft Valuation $ j- New F_Add (< Alter F_Demo # Stories Check Appropriate Box for Applicant/Notification j` 3. Owner's Name Last -rW I7tvluC LflMi✓JfJY First F— Owner's Address Owner's E-mail Address 55ep) 08e) K-T Oren na. City I vewpO-tr -kr/1LH State I C✓ Zip d.b)7 Telephone �( 4. Architect/Designer's Name Last Gys'8� First ,44eMT Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address YJAI WasWRLY ? 6I1A 1? 64 M-M e36 e CD+ZWA'r. eemi City I T g State („9 Zip l�da Telephone yytl_>1_ q13) F_ 5. Engineer's Name Last �L3ERTSOry First A�7zcw Lic. No. 6i6)3 Engineer's Address Engineer's E-mail Address 4/d1 W&STI Y )�,44�,r )ld. CDKWd57-,aM City j,)t./„--F R6,ko State Fa� Zip Ojt66� Telephone I %cf-35)'b3A 1i 6. Contractor's Name Last 4v First d_VLI t; Lic. No. - �Bpp`ClassF _ Contractor's Address Contractor's E-mail Address 8t'�ccfiv� ri7Yc(� City F-5 Chu @ �v Gortry State Zip 9ZP/z4 Telephone bale-3/5-74D j- OFFICE USE ONLY PERMIT NO. ` W1 9'� TYPE OF CONSTRUCTION GG PLAN CHECK NO. 6 6�Ic7 t OCCUPANCY - GROUP PLAN CHECK FEE $ It CO� FiC