Loading...
HomeMy WebLinkAboutX2020-0659 - Permit Application_Print Form Worksheet for Combo Building & Solar Permit Application o4 EWPoRm i- Comm'I r- Residential City of Newport Beach - Building Division � %/�� , ov gq [o NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �� , a.. F -Building F_Grading Drainage [7Elec F7Mech !-Plum Cu Yd Cut !lCu Yd Fill Project Address (Not mailing address) >i Flood F-, Fire i- Liq r Landslide 1N/A Floor Suite No Description of Work Use Const Type #Stories #Units (if Res) LVE"I ' VV'rvi01,f1.t1 (,A.1 OOi/ $ d fj v Material/Labor -Valuation -- RemodelSFF Garage/New/Add New/Add SFr OWNER'S NAME Last �QQ�rf /�2 First A Owner's Address Owner's E-mail Address 4` _ S Nry l�/ _ �/�C�54ACC 62 4m Z_ C im City �GJ/�©�% !jC State Zip `�- 3 Telephone_ APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address = _ Sy'7�j7f<t�Iic— _ /v1Tc C CGn�� Icc�h City �CC✓FD!/L/ State ��� Zip 9�� Telephone 7/1-- 9/3--6?/3 ARCHITECT/DESIGNER'S NAME Last.1-2Z� First /U%I�JR/� Lic.No� j�rCJ �j �( Architect/Designer's Address/ Architect/Designer's E-mail Address `/�, T LZ/C' CJi,.l ' //�..v / TT KC i Z_ l ej�i city '�G?/ D✓-_ NC, -,4C State PA� Zip %-ta V-3 Telephone /3 / ENGINEER'S NAME Last —� First F Lic. No.F Engineer's Address Engineer's E-mail Address City F State F_ Zip �— Telephone[— CONTRACTOR'S NAMEXOMPANY Lic. No. F_ Class Contractor's Address Contractor's E-mail Address .City State r`___7 Zip F_ Telephoner - SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $