HomeMy WebLinkAboutX2020-1364 - Permit ApplicationPf,oi�x Worksheet for Combo Building & Solar Permit Application
❑ Comm'I [residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
wilding E] Grading ❑Drainage ❑Elec ❑Meth ❑Plum cu Yd cut
Cu Yd Fill
Engineer's E-mail Address
Project Address (Not mailing address) ❑ Flood ❑ Fire
❑ Liq ❑ Landslide
❑N/A Floor
Suite No
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Z GAsz-AWA`tS Ne>CZZ 4 REWC-60T
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i State
F7
F-7
Description of Work
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M)ttfIN(q OrzUf 4W'> sTl11�s/Gur< i t_ Stq�1
New/Add SFRemodel SF F77771 Garage/New/Add
Use F7 Const Type
# Stories❑ # Units (if Res)❑
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OWNER'S NAME Last Firstjy1D19(
Owner's Address Owner's E-mail Address
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City 14 MW 170 x 7IrAC,)-) State
Zip ��I TelephoneF4 14 dpZGl 8
APPLICANT'S NAME Last
First
Applicant's Address
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Engineer's E-mail Address
Applicant's E-mail Address
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City
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i State
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Zip
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City
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State
Zip
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Telephor
ARCHITECT/DESIGNER'S NAME Last First
Lic. No.
ArchitecUDesigner's Address ArchitecUDesigner's E-mail Address
City StateZip � Telephone
1
ENGINEER'S NAME Last Ut1la T) A N First p/.1C.r Lic. No. Z—+o 9
Engineer's Address
Engineer's E-mail Address
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City
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Zip
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Telephone
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CONTRACTOR'S NAME/COMPANY p W N tzz Ct / {3V 1 C D }L [L
Lic. No. Class
Contractor's Address Contractor's E-mail Address
City State Zip � Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. XtL) ,
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $