HomeMy WebLinkAboutPV2020-018 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application.
F Residential City of Newport Beach - Building Division
NOTE:. PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Jing r Grading rDrainage F_Elec r Mech r Plum Cu Yd cut Cu Yd Fill
Address (Not mailing address) r Flood j-; Fire r- Liq f— Landslide F_N/A Floor Suite N
on of Work
New/Add SF�, Remodel SF; Garage/New/Add
we o
Use Const Type F
# StoriesF # Units (if Res)
$ -
abor (�
OWNER'S NAME Last First
Owner's Address
Owners E-mail Address
city f � - � State f . ZiP I �f Ll0(/%[�elephone fJjLI Gl l jU� ! L4 >C
APPLICANT'S NAME Last I I) VV _ First �Af n (//l
Applicant's Address `!'� t
Applicant's E-mail Address
%' A, Cpl , �, int lz�vl
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City F— _ ..State �` Zip Telephone��:-t-CX"'a
ARCHITECT/DESIGNER'S NAME Last �; First
Lic No. ��',
Architect/Designer's.Address Architect/Designers E-mail Address
City F� State �� Zip �- Telephoner�
ENGINEER'S NAME Last
First
Lic No.��
Engineer's Address Engineer's E-mail Address
City State �� Zip �� Telephone��
CONTRACTOR'S NAME/COMPANY 1f 1 n
1 V i V I � n P� �— Lic No. Gii�J �.P Class ! ({ �
Contractor's Address Contractor's E-mail Address
City �C State v 1 Zip Telephoned
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SETBACKS. REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE. ZONE DEVELOPMENT NO - PLAN CHECK FEES $