HomeMy WebLinkAboutM2020-0036 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application o4�`We
Comm'I Residential
City of Newport Beach - Building Division
❑ ❑y01NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTATAI.. ,
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❑Building ❑ Grading ❑Drainage ❑ Elec ❑ Mech ❑ PlumYdcut �(7SFill /
Project Address (Not mailing address) ❑ Flood F7 Fire ❑ L L e
Description of Work
Use F7 Const Type
# Storiess # Units (if Res)❑
�j Valuation $
New/AddSFRemodel SFL� Garage/New/Add Material/Labor
OWNER'S NAME
Owner's Address
Last I WANG
First
� Owner's E-mail Address
A
City , , �7771 State Zip Telephone l/
APPLICANT'S NAME Last
First
Applicant's Address Applicant's E-mail Address
City State Zip Telephone)
ARCHITECT/DESIGNER'S NAME Last /f FirstLic. No.�
Architect/Designer's Address Architect/Designer's E-mail Address
C-G{�D_N7-'�7�7h�D��ANA/�{�%�C�Gy� tqK�
city t�Cb r� State Zip 5 e� Telephone
ENGINEER'S NAME Last�w� First t! t,MjF6TLic. No.
Engineer's Address
Engineer's E-mail Address
State
I
Zip
F::711 Telephone
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City
CONTRACTOR'S NAME/COMPANY No. Class
5
Contractor's Address Contractor's E-mail Addres
J
City StateZip �� Telephoned
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
PERMIT NO.
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO _ _ a PLAN CHECK