HomeMy WebLinkAboutX2020-1765 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application "`WPoR2
F Comm'[ FyRe al � (,/ City of Newport Beach - Building Division
"PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rDrainageElec ech% Plum cuvdcutl— Cu Yd Fill
Project Address (Not mailing address) r Flood j Fire[- Liq r Landslide N/ Floor Suite No
Description of Work
Use Const Type
# Stori � �j# Units (if Res)
Valuation $ �?7
Material/Labor
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last First C7`✓
Owner'sAddress Owner's E-mail Address
City �� ._ j� State zjGfF Zip �— Telephone n!
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City /Y . %� A��- StateZip f� Z Telephone e7, 0J�W,�sz,
ARCHITECT/DESIGNER'S NAME Last FirstLic. No. 72 T2
Architect/Designer's Address Architect/Designees E -m Address
�
3� sir ��ce✓i�ie_ ��ove 1-�,aRc�j �',� �`; e
City �SiA j��54 State Zip Telephone
ENGINEER'S NAME Last I �y v� 1 FirstLic. No.�—
V
Engineer's Address Engineer's E 0 ,
', ? I
-m _ress
CjZ V1,W;121
City State ��, Zip Telephone U
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Class
Contractor's Address Contractor's E-mail Address
FIty State 5;,�� Zip P?_7 Telephone
BACKS REAR SETBACKS FRONT PERMIT NO.
4CKS LEFT SETBACKS RIGHT PLAN CHECK NO. IQ 62w
)NE DEVELOPMENT NO 4 PLAN CHECK FEES $