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HomeMy WebLinkAboutX2020-1290 - Permit ApplicationPrint Form Worksheet fo �ombo Building & Solar Permit Application rEW o,. ( Cemm9 Residential % City of Newport Beach - Building Division ��� NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL U(s F uilding �RoGrading [?'trainage lec Fnech ((Project F�lum CuvdCut � CuvdFill Address (Not mailing address) 7 Flood 7 Fire Liq f- Landslide F_N/A Floor Suite No Description of Work Use F—ConstType e_ i w 2.cvcr #Stories #Units (if Res) Gar ^ -�� 2t Vr%r �J i'i�sbl /Add SF ?Jg�j Remodel SF Garag�Add l Valuation $ Material/Labor 7!� f�i��� OWNER'S NAME Last First Owner's Address CLLI `3[.__4_j�' itj - 1Cjhln Owner's E-maillic r s FL ©Ktj City II _ _.. h+( .. �✓- .lf. \ State Zlp '=f Telephon APPLICANT'S NAME Laasttl _I _ First Ilia Applicant's Address Applicant's E-mail Address 245- 3-0 City State �/� 1j"t:1 ac5i, Q w 1, Zip t Telephone T r toZ �(o ARCHITECT/DESIGNER'S NAME Last (V�J First FVJ I �,q— Lic. No. Architect/ /_ _-6esig—neeD Xddress Architect/Designees E-mail Address com City FP State Zip Telephone Rom% 5 ��•� � V ` V ENGINEER'S NAME Last �Mr n� � I First FLA11 Lic No. Engineer's Address Engineer's E-mail Address J 95 � ((� — 5} • Lehi Fj air i�c:G 1 �-� C � 14� 1, City Q-N ._ State Zip � 71+ Z"1 � l Telephone ej �5 • CONTRACTOR'S NAME/COMPANY Lic. No. Class F— Contractor's Address Contractor's E-mail Address J Cit Y F State �— Zip � Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. (� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. vl • USE ZONE DEVELOPMENT NO A v1 PLAN CHECK FEES $