HomeMy WebLinkAboutX2020-1436 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application 0,;_
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F_ Comm'I j- Residential City of Newport Beach - Building Division I Q (1 C4itt t
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_ Building F_ Grading rDrainage F_ Elec - Mech r- Plum CuvdCut CuYdFill F
Project Address (Not mailing address) F_ Flood j- Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
Use F—ConstType F_
AA4— X
r-AkUiI rC-,
# Stories[ # Units (if Res)[
sr-� e
Valuation $
Material/Labor Fo to 0�
New/AddSFF Remodel SF
Garage/New/Add
OWNER'S NAME Last 15&IV5' -L
First
Owner's Address
Owner's E-mail Address
-
City �', j3 State
Zip 1 �176 (U Telephone)
APPLICANT'S NAME Last V(..kU I
First I ,� c.
Applicant's Address
Applicant's E-mail Address
`eS�Tj 'GL1 Pni � ✓ � 2 "�
City n ` 7� State I C,A-
Zip FC-7 6 - Telephone
ARCHITECT,/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
ArchitectlDesigner's E-mail Address
City State
Zip F Telephoned
ENGINEER'S NAME Last 1 )✓A fZ-1G
First - j' CcVJ4 C S Lic. No.1 <:O cii�y
EngineCers Address
Engineer's E-mail Address
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l rrL_ rl/1 U 5 P
City I i__C,<.-i-t_ i t State E" '
Zip f( Telephone F& ZTof -6 (�
CONTRACTOR'S NAME/COMPANY :n -f y -C
—) `
o5i -ry 6 Lic. No. F� Class r�
Contractor's Address
Contractor's E-mail Address
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City Ij State C
Zip /z Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. x' W X • ���4 v
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
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USE ZONE DEVELOPMENT NO �L(/ l • D ��� PLAN CHECK FEES $