HomeMy WebLinkAboutX2020-1060 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application °q =
Comm'I r Residential City of Newport Beach - Building Division -D-w I0' u S�
NOTE- PLAN CHECK FFFR nl IF AT TIKAP nr ¢i IDRAITTAi
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r—Drainage F Elec Mech —P,U1CdCyt Cu Yd Fill
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Project Address (Not
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Description of Work
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Use l;: ConstType k1V
# Stories # Units (if Res)F—
Valuations F ,, -�
Material/Labor
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Remodel SFF— Gara a/New/Add �
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OWNER'S NAME
Last First ^^'
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Owner's Address
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Owner's E-mail Address
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APPLICANT'S NAME
Last �av j First R; —
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Applicant's Address
Applicant's E-mail Address
City � i
State Zip of 6 c Telephone q Pyi--t I
ARCHITECT/DESIGNER'S NAME Last—
i( L Ct L First (latti_j
Lic. No. 3;2 e9
Architect/Designer's Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME
LastsA First F— Lic. No.F—
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Engineers Address
Engineer's E-mail Address
City
State F_ Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY I �twuL�C l ✓T�(/ Lic No. � 6 jeo ClassP , ✓j
Contractor's Address
Contractor's E-mail Address
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State I� Zip 4)4u % Telephone ld y AtI
SETBACKS REAR
SETBACKS FRONT PERMIT NO. �• ' eIQO
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 01-1ID•0:,02.0
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
V Comm'] r- Residential City of Newport Beach - Building Division —'D?i0 io- CI SS z y`
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U
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VR - M ML) 1 Cu Yd Fill l
Project Address (Not mailing address) f Flood Fire --�Li i Gi
q Landslide FN/A Floor Suite No
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Description of Work
ire
J
New/Add SFF—
OWNER'S NAME
Owner's Address
City I/�Gv�c 7 1}2wrn
APPLICANT'S NAME
02 I- ). Y. 4
RemodelSFF— Garage/New/AddF
Last
GI VpN 4<..
State Vs;'
Last I (� 4/
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Applicants Address
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City' State IC¢_
ARCHITECT/DESIGNER'S NAME
Architect/Designer's Address
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City 13C+WTC`..4,
Last I A L Cj�_z,
Dr' te4—
State �—
Use 11� ConstType
# StoriesFT'
Units (if Res)F—
Valuation $ Q cz
Material/Labor C) C100.
First I�
Owner's E-mail Address
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ZIP t z{�_ Telephone R0q ff K/ l 4 Z
First pc-_%
Applicant's E-mail Address
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Zip �C7 6Ct/ Telephone 11TLTtlT)m_
First I a 10fi-Lic. No. TY' -9
Architect/Designer's E-mail Address
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Zip-77Qu, Telephone Zly 6€�zo -ic
ENGINEER'S NAME Last
First F� Lic. No.
Engineer's Address
Engi
�neer's E--mail Address
t
city State �—' Zip I TelephoneF�
CONTRACTOR'S NAME/COMPANY
v tiutL 714 (CtlN /ai Lic No. !�G zee Class e
Contractor's Address Contractor's E-mail Address
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City ' k I d'Pj 0v V'2 State Zip 4 li
f Telephone ,, / y�
SETBACKS REAR �� SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT 7 • t
�— PLAN CHECK NO. �1 b.1a j�,(�
USE ZONE n� DEVELOPMENT NO
PLAN CHECK FEES $