HomeMy WebLinkAboutX2020-2735 - Permit Application (3)Pn1(FArm,, Worksheet for Combo Building & Solar Permit Application
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Comm'I Residential City of Newport Beach - Building Division 'K to U - Vls5 e
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
9jBuilding [Grading []Drainage �;Elec V Mech [Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) [ FloodFire Liq (Landslide [N/A Floor Suite No
L2)5 ELE ►JS dI Q& Gd1JWlJ IzoA D
Description of Work Use Const Type
REOUILD AND (LA i5e ex ISI vo& 0E -ex 1$" OF -P •05(2 AREA, 2 KETAL
i # StoriesF; # Units (if Res)
T12E�L1S 5T24L'rN¢ES p1EW METAL Gt1TER.1G�5TAliL � rJEW cIS GRADE SYAtL
Valuation $Fo,
lD
New/Add SFRemodel SF�Garage/New/Add �Material/Labor
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OWNER'S NAME Last �{RG�ypS First CTEPHAtJIE
Owner's Address Owner's E-mail Address
_71City �— State O Zip Telephoned
APPLICANT'S NAME Last I V (�(a (t^� !� First
Applicant's Address Applicant's E-mail Address
Su- Fic((�in;i c G'c �210�.J � �+�'%>`- C C: j I i 11'Ir • r Q.{
City State � Zip F_ Telephone -k' _ /aLlf
ARCHITECT/DESIGNER'S NAME Last 1-I (ANT FirstGHC-115ArJ � Lic. No. L ----- -
ArchitecUDesigner's Address ArchltectlDesigner's E-mail Address
140 ytAIL 5T 4120 i 0.la�C C c,a_l,�tYtt•��}
City ��- 6Gµ state Zip °IZb(rU Telephone (W� 8sl'Bi4i
ENGINEER'S NAME Last DcI1-IIMI First AMI Lic.No.C78L14____
Engineer's Address Engineer's E-mail Address _
23172 ?LAZA Poi, r
City I L-AGUNA 141&LL1 State Zip °f2(153 I Telephone (p4q�Fs4=7144
CONTRACTOR'S NAME/COMPANY lAy tNf Lic.No. �— Class
Contractors Address C -42t, Ar- I IV s l;U . Contractor's E-mail Address
--------------- -------
City s — _ _ - _- State Zip Telephone
r 1 canl,4 1 i t i VA O.N. e.
3ACKS REAR �-ky, ;b't= i uA:ics rKUN i 11 __>
3ACKS LEFT (9 SETBACKS RIGHT I
—cr--
ZONE ---- .__.-._.-.
DEVELOPMENT NO
F'tKlvll I IVU. /%W1 3- v"" v
PLAN CHECK NO. 10 Z 10 f Zn
PLAN CHECK FEES $ ,._