HomeMy WebLinkAboutX2020-1969 - Permit ApplicationPrint Form ,9 Worksheet for Combo Building & Solar Permit Application
r Comm'[ Residential City of Newport Beach - Building Division��.
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
VBuilding rGrading rDrainage rElec 17 Mech r -Plum cu rdcur Cu Yd Fill
Project Address (Not mailing address) _ Flood r, Fire r, Liq r Landslide rN/A Floor Suite No
/-01, 13E<Vile Z4XIE /v.a.
I F
Description of Work
Use F_,Const Type
# Storied # Units (if Res)
Valuation
Material/Laa bor
Remodel SF-
New/Add SF� �
Garage/New/Add
-
OWNER'S NAME Last GD L G/SUS - - --
----. First -/./ MOT/ y_ __-
Owner's Address
Owner's E-mail Address
/
City State Zip Telephone !�(� _ c�
-- - - 3- d, j�
APPLICANTS NAME Last S-- --- - - � First
Applicant's Address
Applicant's E-mail Address
E
—sv1
City i State F
Zip I Telephone 1/v - 3 y_3 -vyd7S"
ARCHITECT/DESIGNER'S Nj� Last
;First
- Lic. No.
Architect(Designers Address
Architect/Designees E-mail Address
City State
Zip Telephone
ENGINEER'S NAME r/ Last
First Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone)
--
CONTRACTOR'S NAME/COMPANY �7-)p p Ao-cle 9 G� Lic. No. JD f 17ma Class
�1
Contractors Address
Contractor's E-mail Address
City /v�Y>IiA/�/2% Q�(/i/ StateZip
/
- y2l/¢ U 1 Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $