HomeMy WebLinkAboutX2020-2086 - Permit ApplicationPrint Form '' • VVorksheet:for.Combo Building & Solar" Permit Application o��EWPOR@
1_/Comm'I r, Residential City of Newport Beach - Building DivisionXU'2b,. 2NIV
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
[?"Building Grading (Drainage c Mech plum Cu vd curl Cu Yd Fill
Project gqAddress (Not mailing address) F Flood F Fireqq F-; Liq j— Landslide FN/A Floor Suite No
«J1I�n� FZ-('
- -- -------
Description of Work Use Const Type
F_
# StoriesF—# Units (if Res)F_
New/Add SF Remodel SF i 3 6 Garage/New/Add Valuation $ �— Material/Labo
OWNER'S NAME Last ,��,� � �� ; First .^%
Owner's Address Owner's E-mail Address
3�0
City !V�'�✓4 �- �4� «� State (��` Zip 5S Tele hone `
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State Zip Telephone—
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State Zip Telephone
ENGINEER'S NAME Last First Lic. No.1
Engineer's Address Engineer's E-mail Address
City State �— Zip r Telephoned
CONTRACTOR'S NAME/COMPANY yq Lic. No. Class J
Contractor's Address /� Contractor's E-mail Address
-3544S �1 vine- / �v22
City vI" State C"�-. Zip•I 'q(v2 Telephone 114
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $