HomeMy WebLinkAboutX2020-1364 - Permit Application (2)tPrnt'Foem t` Worksheet for Combo Building & Solar Permit Application
❑ Comm'I fi�'fesidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
2fuilding ❑Grading ❑Drainage ❑Elec ❑Meth ❑Plum cu yd Cut Cu ydFill F
'roject Address (Not mailing address) ❑ Flood ❑ Fire
❑ Liq ❑ Landslide
❑N/A Floor
Suite No
z� cAST-AWA `ts N0YZTt4 Re-WRP T
11rEPc() Jz6
0
Description of Work
izM&)TL 3)A#%^,ejv b yli E 5;T-41 us (pV_7 V, -T)
rx�st^,NCz o�cac �>JD S'TJ1Ins��� tzo�L stpl�
New/Add SFF7--71 Remodel SFF7-771Garage/New/Add
OWNER'S NAME Last fzrcwpcLIZI Firstl t`>TZL
Owner's Address
25 C—AS"rAVAY5 NeR-714
City (.iTzwJ'nrYf (3I3p(:-)a State
APPLICANT'S NAME Last
Owner's E-mail Address
mr
Applicant's Address
City State Zip
First
Applicant's E-mail Address
Use F7 Const Type
# Stories❑ # Units (if Res)❑
ARCHITECT/DESIGNER'S NAME Last First F777-71 Lic. No.
17--71
Architect/Designer's Address
City17 State
Architect/Designees E-mail Address
Zip F7� Telephone
ENGINEER'S NAME Last `' l lt2d;, 7! A hl. I First � Lic. No. Fi5
Engineer's Address
1--" w . V-A TC" A V r R11 iz
City State
Engineer's E-mail Address
i?otzriia Q vpttZzµtttri t4)4 -co"
Zip '9Z8 (off Telephone X14 9,r_7 I 45
CONTRACTOR'SNAME/COMPANY owtiVm/pVtC_%>1rZ_ Lic. No. F-7771ClassF
Contractor's Address
City _ State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
Contractor's E-mail Address
Zip L� TelephoneCi
PERMIT NO. H9.0712 �
PLAN CHECK NO. 1 /7S/_ —
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $