HomeMy WebLinkAboutX2020-2372 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
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City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
JSSBuilding F_ Grading -Drainage Elec FMech
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Project Address (Not mailing address) F_ Flood r Fire r" Liq f- Landslide F_N/A Floor Suite No
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Description of Work
Use I— ConstType
IF Stories # Units (if Res)F_
Valuation F32 'New/AddSFRemodelSF `'cc-)
Gara a/New/AddMaterial/Laabor
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OWNER'S NAME Last L-JEVy
First J(�A-Q ilJ%zr
Owner's Address
Owner's E-mail Address
City � State C4
Zip �20� Telephones
APPLICANT'S TAME Last AI>57�N
First
Applicants Address tiy-
Applic(arift E-mail AAddre�ssIr
City rly 64� State F��
Zip Telephone _79�_yr,'
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ARCHITECT/DESIGNER'S NAME Last ZHfL,pS
First C�GciJd/� Lic. No. C zzlej6-
Architect/Designer's Address
ArchitecUDesigner's E-mail Address
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City I C,9A0A A pe:z /y4p State i A
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Zip � � � Telephone
ENGINEER'S NAME Last �—
First Lic. No.F
Engineer's Address
Engineer's E-mail Address
City State F—
Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. I Class
Contractor's Address
Contractor's E-mail Address "kW
(1
City State �-
Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ^
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. `�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $