HomeMy WebLinkAboutX2020-2165 - Permit ApplicationPunt Form y Worksheet for Combo Building & Solar Permit Application "°
Comm'I Residential City of Newport Beach - Building Division' 2 ��
r NOTE: PLAN CHECK FEES DUE AT TIME OF SUBM�TTAL 2T G<.oa '
FBuilding (-!Grading rDrainage r✓Elec ;7Mech Plum curdcutF CuvdFill F'
Project Address (Not mailing addre�sss))g r Flood r Fire [7 Uq r Landslide rN/A Floor Suite No
Description of Work
Use Const Type
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V
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# Stories #Units (if Res)
Valuation $
Material/Labor
New/Add SFF__ Remodel SF�—
Garage/New/Add F7—:—
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
- - --j -
City State Zip F Telephone
19
APPLICANT'S NAME Last
First pyl
Applicant's Address
Applicant's E-mail Address
city State
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Zip Telephone t.�q°G•�O�l�
ARCHITECT/DESIGNER'S NAME Last F First F Lic. No.
Architect/Designees Address
Architect/Designer's E-mail Address
City �— State
Zip Telephoned
ENGINEER'S NAME Last
First —, Lic. No.r—
Engineer's Address
Engineer's E-mail Address
City _ State
Zip I Telephone—
CONTRACTOR'S NAME/COMPANY
Lic: No. F Class F_
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F Telephoner
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SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. t