HomeMy WebLinkAboutX2020-2151 - Permit ApplicationPrint Form:
Worksheet for Combo Building & Solar Permit Application
comm'I r esidential
City of Newport Beach - Building Division X 7,07/v ZA
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Project Address (Not mailing address) Flood (-', Fire [I Liq rl Landslide F_iN/A Floor Suite No
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Description of Work
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Use Const Type �l
# StoriesF7# Units (if Res)n
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Valuation $ r. ilrl.iPi1
Material/Labor
New/Add SFFj
Remodel SF �I Garage/New/Add
OWNER'S NAME
Last -, First j -- - -
Owner's Address
Owner's E-mail Address
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City �j - ,)
StateZip F Telephone
APPLICANT'S NAME
Last First
Applicants Aojess
®® Applicant's E-mail Address,
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city � ,L
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` tate Zip Telephone 2/71Gd�r
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ARCHITECT/DESIGNER'S NAME Last /� f�� // �/ h / F' Lic. No. - G
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ArchitectlDesigner's Address
Architect/Designees E-mail Address
City State Zip �— Telephone�—
ENGINEERS NAME�G
Lic. No f
Last _ I First � I _
Eng' er's Address
Engineer's E-mail Addres
Cityvo I i - 4e, bl g " Zip t� �� Telephone
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CONTRACTOR'S NAMEXOMPANY
t A] E� .I� Lic. No. lass
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Contractor ddress
Contractor's E-mail Add�pss
City�
State!, Zip a Telephon ®07
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SETBACKS REAR
SETBACKS FRONT PERMIT NO. �ui• a1 �'
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK O.
USE ZONE
DEVELOPMENT N•Om PLAN CHECK FEES $