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HomeMy WebLinkAboutX2020-1996 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application g �'° City of Newport Beach -Building Division �/, p o r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL /tG 0`Lc I l FX Building (-`Grading rDrainage F_Elec (-Meth r- Plum cuvdcut[— CuvdFillF_ Project Address (Not mailing address) r Flood r Fire r Liq r Landslide rN/A Floor Suite No 250'% AL LL Ye Description of Work r Use T�. Const Type 6 # Stories #Units (if Res) � r��� emo {olck QcvY aL �amtL� ,d). nValuation New/Add SF _\ Remodel SF Garag F a/New/Add Material/Labor \ 9 OWNER'S NAME Last First _ Gk,,-)vL- tkh Avfp i J Owner's Address Owner's E-mail Address 250-7 Aar6ove _ bli City I N iV) P011" e)eaQk State CA Zip F_ Telephone IJ,14 110 A APPLICANT'S NAME Last Richart First Jason Applicant's Address Applicant's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ARCHITECT/DESIGNER'S NAME Last Richart First Jason Lic. No. �— Architect/Designer's Address Architect/Designer's E-mail Address 1041 W. 18th St, (A106) Jason@richartdesign.net City Costa Mesa State CA Zip 92627 Telephone 949-422-9191 ENGINEER'S NAME Last ✓11Tc First Lic.No.I Engineer's Address Engineer's E-mail Address 4?)mb Q x_ eeY _ P, s e. 2®`� City TCJ_me_ State F CA. Zip i �,�-j��© Telephone g G I a Fj �� 7H CONTRACTOR'S NAME/COMPANY Lic No. F Class Contractor's Address Contractor's E-mail Address City �— State F Zip F Telephoned SETBACKS REAR SETBACKS FRONT PERMIT N0. qY/ SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO, USE ZONE DEVELOPMENT NO PLAN CHECK FEES $