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HomeMy WebLinkAboutX2020-0930 - Permit Application?nrat dorm Worksheet for Combo Building & Solar Permit Application [- Comm,l Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Via„ [-Building [-Grading [—Drainage [-Elec [-Meth [-'Plum Cu YdCut F_ Cu YdFill F Project Address (Not mailing address) Flood [- Fire [- Liq F, Landslide [-N/A Floor Suite No 60, base Description of Work Use Const Type F r # Storiess # Units (if Res)F i New/Add SFr— Valuation $ Remodel SF Garage/New/Add ��' Material/Labor O ®Q 0: OWNER'S NAME Lastl I't`9t�(!-. First. 4�S�q - �/((7(� r Owner's Address Owner's E-mail Address City—�� State Zip F____7 Telephoner APPLICANT'S NAME Last � J 9Val,n First a. ,.. Applicant's Address 0 Applicant's E-mailtAddress'I ` rSor lv City !� State Zip '126 3 Telephone 31�`�Qrp. Qh9 ARCHITECT/DESIGNER'S NAME Last ��f First I Lic. NNoo. Architect/Designer's Address Architect/Designer's E-mail Address City f � State F_ Zip F_ Telephoner ENGINEER'S NAME Last First F�' Lic. NoF�', Engineer's Address Engineer's E-mail Address City �— State �— Zip Telephone CONTRACTOR'S NAME/COMPANY Y\ U VV �( h Lic. No. -I tjSS 1 0 Class' Contractor's Address l� +Crontractor's E-mail Address NrV` eta �toS, com City r�i � State ZipF?_a _e Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. K7,t JZ (A-�Sd SETBACKS LEFT SETBACKS RIGHT 1 PLAN CHECK NO. /19 6Sa ._ Z_02 USE ZONE DEVELOPMENT NO ��(}�� ti I (� PLAN CHECK FEES $