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HomeMy WebLinkAboutM2020-0048 - Permit ApplicationPrint Form__ Worksheet for Combo Building & Solar Permit Application ga r comm'IResidential City of Newport Beach - Building DivisionNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL (X•Building r Grading rDrainage r Elec r Mech r plum Cu Yd BL1C C1GYQI Project Address (Not mailing address) F_ Flood r; Firer Liq r' RMIT Suite No 1(sc) { 13Ql�ua csly Ike J�orF,c�WP RT BE CH Description of Work .Use\p��y��� d_ YPe Stories'. # Units (if Res), Valuation $ Material/Labor 'i (p �M 0 New/Add SF� Remodel SF Garage/New/Add —, OWNER'S NAME Last C1'�-yv�� First eLk�,x Owner's Address Owner's E-mail Address q F co City p 2t Q Qar $ ii za t lh State �— Zip - 3 �.f2 � P '; Telephoneff`(' S— APPLICANT'S NAME Last / 1 \r �First Applicant's Address Applicant's E-mail Address City �— State F—: Zip Telephonel— ARCHITECT/DESIGNER'S NAME Last 7— ', First F-- Lic. No. Architect/Designees Address Architect/Designer's E-mail Address City State �—, Zip �— Telephone F ENGINEER'S NAME Last r— First Lic. No.F— Engineer's Address Engineer's E-mail Address city r-- State r-- Zip r-- Telephone—, CONTRACTOR'S NAME/COMPANY Apex Diving and Marine Services, Inc. Lic. No. 0006937 Classy—' Contractor's Address Contractor's E-mail Address 15061 Sherman Way, Unit J phildamico@apexdiving.com City Van Nuys State CA Zip 91405 Telephone 949-590-9966 SETBACKS REAR SETBACKS FRONT PERMIT NO. I✓�%�� —� SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. I �U a — Z© tD USE ZONE DEVELOPMENT NO PLAN CHECK FEES $