HomeMy WebLinkAboutM2020-0046 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 04 gWPoq
Comm'I r Residential City of Newport Beach -Building Division o s
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL tAZ11z0' OWL
F-Building F_ Grading F-Drainage f Elec r Mech j` Plum CuwdjCCuut ,� W —
Project Address (Not mailing address) F- Flood (- Fire r- Ligr Landslide ,AI ��r Suite No
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Description of Work
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#Stories #Units (if Res)
Valuation a 1 C. ` C C,
Material/Labor
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New/Add SFF Remodel SF �—
Garage/New/Add �—
OWNER'S NAME Last j� S L <. �_ (�j c .�
C ( U C First
Owner's Address
Owner's E-mail Address
1 -J-I Lam; C C,, T�L_ j
City C; State 1 Zip Z-(� O TelephoneF—
APPLICANT'S NAME Last l_ m I i l Li/
First 7C, c`
Applicant's Address
Applicant's E-mail Address
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City ��', t c. 1 l.� hcti_ State �' ,
Zip Cil Z k ') Telephone (</
ARCHITECT/DESIGNER'S NAME Last First 7� Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State F—
Zip I Telephonel—
ENGINEER'S NAME Last rqt ,
First k rt, ,lc L � Lic. No:5
Engineer's Address
Engineer's E-mail Address
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City tC I State C rl
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Zip C(! k j� Telep hone
CONTRACTOR'S NAME/COMPANY C I— C. Lic. No. 51 r( Class ()r (�
Contractor's Address
Contractor's E-mail Address
�531 � _ t* S�
City l �, �cti �� L� J State
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Zip 717 f 1..3 TelephoneFl t CI
SETBACKS REAR SETBACKS FRONT
PERMIT NO. M �o — M U
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. �2
1ISF 70NE rIM/M nPRAPNrr NO
PI AN CHECK FFFR R