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HomeMy WebLinkAboutx2020-2597 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application City of Newport Beach -Building Division yy�a� j )` Comm'I (` Residential g J� �tB �� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL F -Building Grading I -Drainage F_Elec F7Mech r- Plum Cu Yd cutF Cu Yd Fill Project Address (Not mailing address) FFlood r Fire 17 Liq r Landslide FN/A Floor Suite No Description of Work Use � ConsbType A4" A&-- .- Cx447 . J / /�°ic S:i4e% /2 CT J ICU!/4- /��; �� �% o-' # Stories #Units (if Res) New/Add SFI— Valuation $ RemodelSFI— Garage/New/Add—_ Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Address City Icer -A- r J+- State sZ ZiP Telephone �f �"Wo APPLICANT'S NAME Last �- First Applicant's Address Applicant's E-mail Address City State Zip Telephone— - ARCHITECT/DESIGNER'S NAME Last �- First F Lic. No. Architect(Designer's Address Architect/Designer's E-mail Address City State Zip �— Telephoner ENGINEER'S NAME Last First Lic. Engineer's Address Engineer's E-mail Address City State F_ Zip i Telephoner— elephonerCONTRACTOR'S CONTRACTOR'SNAME/COMPANY Lic. No. 17�96 3 ,Class FC /i' T Contractor's Address Contractor's E-mail Address ` d G�.1 d'i°r-rs e�� .h c:�y EJ. ' / /�TE3.'''a Cc�eG^, e'•z ��/ �x ,/ _ e a-_ '. City L���.,�s </lr State 4�rA Zip �'2�5-? Telephoneeee1Z L/47/ SETBACKS REAR SETBACKS FRONT PERMIT NO. Vzosi. 11ol SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. fAwt .14M USE ZONE DEVELOPMENT NO PLAN CHECK FEES $