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HomeMy WebLinkAboutX2020-0570 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application n44,_. City of Newport Beach - Building Division ��// c 7Dr, Comm'I ( Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL J Ab5 V j— Building I`, Grading [—Drainage rl Elec I —I Mech [I Plum Cu Yd Cutl Cu Yd Fill 17 Project Address (Not mailing address) F_Flood [_i Fire r_, Liq F Landslide F_'N/A Floor Suite No Description of Work Use Const Type # StoriesF # Units (if Res) ' IPA- X 4 Valuation $ Material/Labor New/Add SF Remodel SF Garage/New/Add �� OWNER'S NAME Last �Aa-"O First r� Owner's Address Owner's E-mail Address C_ - -city 1 'J3 State Zip �' Telephoner APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address City State ZipZip Telephone ARCHITECT/DESIGNER'S NAME Last I - First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State �� zip I Telephoned ENGINEER'S NAME Last First Lic. No. Engineer's Address Engineer's E-mail Address City i State �` I Zipi Telephone — CONTRACTOR'S NAME/COMPANY �- M - Lic. No./ Class I 1 �C25 slop" v c Contractor's Address Contractor's E-mail Address J �p00 n c 'J✓ �lt l.)U l � FU 6,) pr�1�lT- .�2S c - G u57 o A,, City State Zip 2(Q(o© Telephone SETBACKS REAR SETBACKS FRONT U7 PERMIT NO. •QS� D SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ (11�• �A� '[YLb19.03'1�