HomeMy WebLinkAboutM2020-0021 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application (14P
F_Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building F_ Grading F-Drainage r Elec F_ Mech
j— Plum CuvdCut CuvdRI s
Project Address (Not mailing address) F_ Flood F_ Fire F_ Liq F_ Landslide N/A Floor Suite No
Description of Work
Use ConstType F
'' //
ems
,A / �� W� �
# Stories # Units (if Res)[_
Valuation $
New/Add SF F Remodel SF F Garage/New/Add �— Material/Labor
OWNER'S NAME Last ?C&4 First 1V14i2.6_,
Owner's Address
Owner's E-mail Address
1 O -7 2"l 'E t D &e- t. JA- Y
City I TitSTj/`/ State Gq
Zip C Z 8 Z Telephone 11.4 3(pg-0388
APPLICANT'S NAME Last iZ
First /r'q/'--k-
Applicant's Address
Applicant's E-mail Address
10129 OaIDC-E0- IJR-Y
City I _rL49 '/ h( State CiZi
Zip Zyb Z Telephone 7(q 3(e8-031M
ARCHITECT/DESIGNER'S NAME Last First (/Offer Lic. No. E ZZSG
Architect/Designer's Address
Architect/Designer's E-mail Address
10&tP)7, g CEfrnc�r�7 /� ✓e
/_;'z09C-6r462C�W/7t-zTe2w CA,�,Co,
City Tu5T/t__i State C(i
Zip 7_70s Telephone 7/� 1W 2-723
ENGINEER'S NAME Last
First Lic. NoF
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY ��(+ E7IrGIAJEE2ln4t✓ Lic. No. F7oi,3Q/5 Class
Contractor's Address
Contractor's E-mail Address
ol w.
MAiz-kl�c5 @ M coM
City I $EAu. rnowr State G)
Zip q ZZ ZZ3 Telephone go9 37, -Z7z3
SETBACKS REAR SETBACKS FRONT
PERMIT NO. Nf \ 2C' 2- 41—
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO -
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $