HomeMy WebLinkAboutX2020-1159 - Permit ApplicationWorksheet for Combo Building & Solar Perm't A
Comm'I r Residential
'Building r Grading
Project Address (Not
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Description of Work
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City of Newport Beach - Building Division �/7 nq � - ((5n
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT "'
r-Drainage �(j `Elec
Cu Yd Cut
F Flood r Fire r" Liq r Landslide
New/Add SFF Remodel SF �y� 11
OWNER'S NAME Last
Owner's Address
City �Fa ��7p: State r.'m
APPLICANT'S NAME Last
Applicant's Address
City 3 ( State
ARCHITECT/DESIGNER'S NAME
Cu Yd Fill
rN/A Floor
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Suite No
id
Use =� ConstType i„
# Storles� # Units (if Res)
Garage/New/Addy IValuation
a
Material/Labor
First
Owner's E-mail Address e% ) ZipI Telephony c=V /G� %c2/hB
j First
Applicant's E-mail Address
Zip Telephone ' t '�
Last °iY� 1 _. .....
�::.. First —Lic. No. k
Architect/Designer's Address i
City�� State
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ENGINEER'S NAME Last L ,rZ✓ll
Engineer's Address
i �/
City State
Architect/Designer's E-mail Address
e .
Zip Telephonj`177
First WI E Lic. No. � �j � 7
Engineer's E-mail Address
Zip . 4 Y /w�
Telephone F.. t� j
CONTRACTOR'S NAME/COMPANY
1-1 tl Lic. No. Class�—
Contractor's Address
City
State
SETBACKS REAR
SETBACKS FRONT
Contractor's E-mail Address
Zip / Telephone
SETBACKS LEFT
USE ZONE
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO. I #jf r -► S
PLAN CHECK NO. I LaxL,a
PLAN CHECK FEES $