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HomeMy WebLinkAboutX2020-2438 - Permit ApplicationPnnt•Form `' Worksheet for Combo Building & Solar Permit Application C Comm'[ IS[T Residential City of Newport Beach - Building Division �(Z Ott ' ZN 3g i NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ISQBuilding [7, Grading FJDrainage ❑Elec [Meth Ej Plum Cu YdCut F�_11 Cu Yd Fill `Project f Address (Not mailing address) [ Flood G Fire [] Liq G Landslide (_IN/A Floor Suite No ll Aorr�v w ,& c')f Description of Work Use �i Const Type # storiesC�# Units (if Res) FiMlrhr ca+4�r Valuation $ — New/Add SF1 -9- Remodel SF1 7T Garage/New/Add Material/Labor OWNER'S NAME Last cTf/FP/1CRj: First Owners Address Owner's E-mail Address cvwc'di'Yer eQm xcr . cam City x/g/wesrleg State F�j Zip 9'2(�(e� I Telephone ,?" APPLICANT'S NAME Last c.%Kw- First 1!W15_71/A,1x Applicant's Address Applicant's E-mail Address �/1 g •9—Btt-n. ! �hrisf m63P. 1xAov,cPw, city��/C,�-/3 .� State Zip 9y�6(p/ Telephone ARCHITECT/DESIGNER'S NAME Last IFirst j Lic. No. • 23�,f Architect/Designer's Address Architect/Designer's E-mail Address Pk/ , lla,(IJ7 4R1 fl - Ycwt mAr4ih xrob ifectC'i9v„aiI co VV, city I/VrriAM_1 4 i State Zip p2lo/vO Telephon WR_40?p'7 I ENGINEER'S NAME Last I ,$©a'`✓� First Lic. No. !r Engineer's Address Engineer's E-mail Address City L- �UN�f'" HjLL-S State Zip 7,(�S'(p Telephone CONTRACTOR'S NAME/COMPANY�i Y. �.Zl✓�S Lic. No. lass ��'y% Contractor's Address Contractor's E- ail Address / Yet $tate [ ', Zip Telepho 7/6�) 3 7/— 3Z L SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. z:OSS- XuD I ICF 70KIP 1.11.11 r......-- 11 ... 11.11 ..Cc G