HomeMy WebLinkAboutX2020-2818 - Permit ApplicationPrint Form _i Worksheet A
rksheet for Combo Building & Solar PerrA ppf"IEVion" �?
r Comm'I (" Residential 1' r1v$0' 74 1 Y City of Newport Beach - Building Division �/L,
NOTE PI AN r.HFCI( FFFR n, idnT Tann❑ nc ci IDRAITTA I 7
Building r— Grading
Drainage rElec j`/ffech Plum C. ydcuts Cu yd Fills
Project Address (Not mailing address) I! Flood L" Fire F_ Liq F_ Landslide FN/A Floor Suite No
A 4 F_ C_
Description of Work
Use F—Const Type F_
fzi(5adL 0 ✓>at,
f ' "J 'o4L r�44,Tt t4
#Stories # Units (if Res)s
Valuation $ F
Material/Labor
�'-'
New/AddSFI(s�
r �2�
OWNER'S NAME
Last pa 48CLL FirstC.4`k�C-rl��
Owner's Address
Owner's E-mail Address
IWO-
City lu 5✓(301 r 5V.NC A_ State CA Zip �2� t Telephone F-7 to .c( 3`7_ St ci�
APPLICANT'S NAME
Last F First
Applicant's Address
Applicant's E-mail Address
�io2Z dre �rLFA PC&.
City F --40p, .
_ State Zip 1116 . BG Telephone -I d 4. t s 6 , 2605
ARCHITECT/DESIGNER'S NAME LastwcxziC-'51;-aT First 6i d.6
Lic: No. �-----
Architect/Designefs Address
Architect/Designer's E-mail Address
56'Z1.. I:.a.
Ole. in)e.�e�asSgS �gN.a�aC.
City r—.B ,, � ,
State FC ZIP�1, 4 TelephoneF7 l�', a (9 - ?,GO'5
ENGINEER'S NAME
Last First (&�ygi.a.(,p9 Lic.No.'K7 Tc.1
Engineer's Address
Engineer's E-mail Address
City
State --_.-.- Zip r .— 6 Telephone ;ji4. 1'3®77 ,"1L't, I `..
CONTRACTOR'S NAME/COMPANY r 'Lir F--'- Class
Contractor's Address -
- Contractor's E-mail Address
City F---.....---
State�W ZiP.�.__._ Telephoner-._---_
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT .PLAN CHECK NO,
USE ZONE
DEVELOPMENT NO .PLAN CHECK FEES $