HomeMy WebLinkAboutPV2020-066 - Permit ApplicationPrrtForm ;' Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division PV,7®20 - 0EE
F_ Comm'I Fl Presidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F�IIding F_ Grading (—Drainage I"..Elec f Mech r— Plum Cu Yd Cut] Cu Yd Fill
ect Address
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)escription of Work
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F_ Flood F_ Fire (- Liq r Landslide F_ N/A Floor Suite No
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# Stories # Units (if Res)F_
29 Oct so wt
—. Valuation $ 1
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OWNER'S NAME Lastl . s/L�l FirstI Vo_ q
Owner's Address Owner's E-mail Address
City I (�}Co/ls State I � Zip ojZ(p2s Telephone qL/'3355.- 6 Z$ _
APPLICANT'S NAME Last 5 First I 5 eph
Applicant's Address Applicant's E-mail Address
City C��i/�,� State Zip 7..✓ Telephone[ cr9�321o�3/(pZ—
ARCH ITECT/DESIGNER'S NAME Last First �W Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip �� TelephoneF
ENGINEER'S NAME Last i)XA� G , � First Lic. No.
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Engineer's Address Engineer's E-mail Address
City H, U State 1C/� ZipFc2(4 q (a Telephones (c/Zz(51 )Zg 5_.51 C)1
CONTRACTOR'S NAME/COMPANY I� r� �� / r �6 / Lic. No.l (,Zgu Class6t(j
Contractor's Address J Cwt i -C Contractor's E-mail Address
City Cds4-6- Mcl_ State Gfi— Zip`IZc_27 Telephone COQ 149- 3933
SETBACKS REAR
SETBACKS LEFT
SETBACKS FRONT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NOIR I-1 • �/1/J PLAN CHECK FEES $