HomeMy WebLinkAboutX2020-2655 - Permit Application�__ Print Form___ I Worksheet for Combo Building & Solar Permit Application
r Comm'I XResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F__ CuYdFill '10
F_ Building F_GradingArainage F_Elec r—Mech F— Plum CuvdCut
Project Address (Not mailing address) F_ Flood r Fire F- Liq r Landslide rN/A Floor Suite No
Description of Work
Use F—ConstType F_
AAi�,iN6 ABOVE EAI► TI6 Q90Nl W)ffl
i U& Ar i�/ A I� i��r
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l /
# Stories #Units (if Res)
New/Add SF � R
Remodel SF ;1, 1 6
Valuation$
Garage/New/Add Material/Labor 10 �JV
OWNER'S NAME Last NWA
First f j�} 0 Y 1
Owner's Address
Owner's E-mail Address
2U I �6767t At iJ}
Aqh-AG,,Vnc 6-r.Ise-T
City � C State i
zi[ETp Tele hone ti6, r9
APPLICANT'S NAME Last LA C �/ 0ulAl r— First
7
Applicant's Address
Applicant's E-mail
LLA,,,�ddresss1 �L
C( R'(,c dl+ S/; , c� ,-J + C 7yi CifS�, 1? L
City � State �
Zip � Telephoner—
ARCHITECT/DESIGNER'S NAME Last I f �c6V First N -AgZ2-
v Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
�K'`AVE AVENUE
n d1, ; a rch ifeJ P_TWc . crvw
City rWW�� pffi State a
Zip Telephone
ENGINEER'S NAME Last
First F Lic. No.F
Engineer's Address
Engineer's E-mail Address
City I State F_
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- ClassF—
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. Z%
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES I� ( I