HomeMy WebLinkAboutX2020-0146 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ma'a
F_* Comm'I F _ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FFFS pip: oT TMAP nr ci IDRA17TAi
F -Building F_ Grading I -Drainage F-, Elec I-Mech [-plum Cu Yd Cut F' Cu Yd Fill
Project Address (Not mailing address) FFlood F` Fire F- Liq [_ Landslide F_N/A Floor Suite No
-�F 37 ? - 6,)14 F_ Fi
,
Description of Work
Use �, Const Type
-
V
# Stories # Uniitts (if Res) '
o b3 6
New/Add SFF— Remodel SF Garage/New/Add
Valuation $
Material/Labor �a`QgV
OWNER'S NAME Lash �Q / y�� 5
I v �A''->J - First
Uri--
-� - -A
Owner's Address Owner's E-mail Address
_4Ok �GSO(I _ /R°
City State Zlp Telephone[��
APPLICANT'S NAME Last N First r5'i1lG�
Applicant's Address Applicant's E-mail Address
City - State Zi Telephone
p R7lyt�L�p37tg
F ,4 -'�i — — A
ARCHITECT/DESIGNER'S NAME �/'1'��
Last ' First � �Lic. No.
i
Architect/Designer's Address �jjt,'��i Architect/Designer's E-mail Address
z9 1 Gri _ l�Li2rr9r�F GA) e0:T47 � A,r2G• 6on,
City F �i4 1 - State Zip Telephone '761% j ",',O -f 7p
ENGINEER'S NAME LastAVFirst v Lic. No. FS
" ` lV4�2 ,,� _
C.J
Engineer's Address �J
Engineer's E-mail Address
City.. -..._ State F_ Zip — TelephoneF� -..... _
CONTRACTOR'S NAME/COMPANY F� Class
Contractor's Address Contractor's E-mail Address U 'Sfo j
City r� . State F Zip r TelephoneF�. -
SETBACKS REAR SETBACKS FRONT PERMIT NO. )CZQZU - O k9 6
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. Qi l eb , Zu Zp
USE ZONE DEVELOPMENT NO 00VIKAN CHECK FEES $