HomeMy WebLinkAboutX2020-2696 - Permit ApplicationPrint Form I Worksheet for Combo Building & Solar Permit Application o��EWP°Re
Comm'I Residential City of Newport Beach - Building Division�^l &'
NOTE: PLAN CHECK FEES DUE AT TIME OF SUB MITT AL��
F Building FX_ Grading F) Drainage fX— Elec FX_ Mech (X Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) FX_ Flood (X Fire FX_ Liq FX_ Landslide (XN/A Floor Suite No
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Description of
New/Add SF '} - Remodel SF
# Stories '2 # Units (if Res)j
Valuation $
Garage/New/Add F Material/Labor
OWNER'S NAME
Last � First f ,4 ,U & /AJ i
Owner's Address Owner's E-mail Address
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City �� (?,(� State C.A Zip y Telephone �14`t
APPLICANT'S NAME Last I l_ t
Applicant's Address
city p,A
ARCHITECT/DESIGNER'S NAME
Arch itect/Designer's Address
City
First 1 te0l' P0 ' L 10,N dz /A-t
Applicant's E-mail Address 7
State u Zip F-®cm,5 - Telephonel (1,tg_ 6 44
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Last First
� pit / Lic. No. F�
Architect/Designer's E-mail Address
State Zip-�- - Telephone 62 --
CONTRACTOR'S NAME/COMPANYC ic. No. /61 _111 - Class
Contractor's Address Contractor's E-mail Address z / 5
V '
City State Zip Telephone �1� -Z1-0
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $