HomeMy WebLinkAboutX2020-1616 - Permit Application (2)ku,2D - t got t�
Prins. Fam Worksheet for Combo Building & Solar Permit Application saw
F- Com"'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL.
r -Building -Grading j Drainage F_Elec r"Mech F- plum Cu Yd Cut F_Cu Yd Fill
Proj ect Address (Not mailing address) F_ Flood F- Fire F- Liq F_ Landslide F_N/A Floor SuiteNo
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Description of Work
Use ConstType
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# StoriesF # Units (if Res)
Valuation $
Material/Labor
New/AddSFF_, Remodel SFF—
Garage/New/Add—
OWNER'SNAME LastMUiF�
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First
OwnePsAddress
Owner's E-mail Address
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City FT '�j State I Zip Ft / Telephoner / / 5 _-11��
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APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City F State F�
Zip-TelephoneF_
ARCHITECT/DESIGNER'S NAME Last OR6AV ---', First ' Lic No. C�i�
Architect/Designer's Address
Architect/Designer's E-mail Address
71'-CR?44-?;K-Coif.
City , W. State l ;rte/r Zip , Telephone/[,( 736 p 7l72
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ENGINEER'S NAME Last
First �� Lic. No.
Engineer's Address
Engineer's E-mail Address
City State [_
Zip [_ TelephoneF�
CONTRACTOR'S NAME/COMPANY
Lic No. F—Class
Contractor's Address
Contractor's E-mail Address
City State F
Zip F_' Telephone[�
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ .�