HomeMy WebLinkAboutS2020-0126 - Permit ApplicationPrint Form <p Worksheet for Combo Building & Solar Permit Application
F Comm'I residential City of Newport Beach - Building Division LoZo
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
54wlding r Grading rDrainage r Elec r'Mech r Plum Cu Yd Cut F Cu Yd Fill
Project Address (Not mailing address) r, Flood I- Fire r Liq FLandslide FN/A Floor Suite No
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Description of Work
Use ,, Const Type
# Storiesj # Units (if Res)
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0%."d CT S;tQ ✓�
Mate al/Labor
New/Add SF _ y3ss Remodel SF�— Garage/New/Add F
OWNER'S NAME LastFirst
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Owner's Address Owner's E-mail Address
City bd { f V e4c(t State C(� Zip Telephoned
APPLICANT'S NAME Last V4 j&c Av First /a -
Applicant's Address Applicant's E-mail Address
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City C C-1 U v _... t 1 c (k S State C 4 Zip 9 7. Telephone[-70-1-
elephone70-1-ARCHITECT/DESIGNER'S
ARCHITECT/DESIGNER'SNAME Last First Lic. No.
Architect/Designees Address Architect/Designer's E-mail Address
City State F_, Zip I — Telephoned
ENGINEER'S NAME Last � First [Lic. No.F—',
Engineer's Address Engineer's E-mail Address
City State F_ Zip �— Telephone—
CONTRACTOR'S NAME/COMPANY/ Lic. No. �� Class
Contractor's Address ��?4Cm�l s Contractor's E-mail Address
City C In i lr'`S lv\y15j State I CC4- ZIP %_7 05 Telephone (Y9�(� 8ff0
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SETBACKS REAR SETBACKS FRONT PERMIT NO. S U7 OI? ,(
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
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