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X2020-0514 - Permit Application
(E) Print Form Worksheet for Combo Building & Solar Permit pli a i ?E� > Comm,l Residential City of Newport Beach - Building Division �1 ' v NOTE: PLAN CHECK FEES DUE AT TIME OF SUR ITTAI c. j wilding ❑Grading ❑Drainage lec ❑ ech um cu vd CutF71 Cu Yd Fill Project Address (Nott mailing address) ❑ Flood M] Fire ❑ Liq [7 Landslide ❑N/A�F�llll000rorJ Suite No Description of Work UseF7 Const Type ' = 17010/, # Stories # Units (if Res)F7 Valuation $ New/Add SF Remodel SF D S Garage/New/Add F— _ Material/Labor CJ OWNER'S NAME LastL ?' Q I_— f — First Owner's Address Owner's E-mail Address LOU kol AI �o.� -- City y�/ ��/�N r� _�� State Zip 6S�-- Telephone - �lC� APPLICANT'S NAME Last v First / Applicant's Address Applicant's E-mail Address City _-- State J Zip Telephoned J ARCHITECT/DESIGNER'S NAME Last Vol,) I First 7rttLic. No. G Architect/Designer's Address Architect/Designer's E-mail AV — - --- — city r�Ia-." _'_ �Ol/ ._ State _ Z1p a l elephone r-�© ��9 ENGINEER'S NAME Last First� Lic. No. —_ _7 Engineer's Address Engineer's E-mail Address City -_---_ ---_-- --,_ State 17-7 Zip Telephone�� CONTRACTOR'S NAME/COMPANY Lic. No. Class Contractor's Address Contractor's E-mail Address City _- _ ., - State I Zip 1 Telephone=_ SETBACKS REAR SETBACKS FRONT PERMIT NO. ZZOZO — C S 1L' SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. CMG T USE ZONE DEVELOPMENT NO PLAN CHECK FEES $