HomeMy WebLinkAboutX2020-2988 - Permit Application.Print Form " Worksheet for Combo Building.& Solar Permit Application
j— Comm'I r-y, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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F- Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) r Flood r Fire F_ Liq r Landslide F_N/A Floor Suite No
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Description of Work
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# Stories # Units (if Res)F
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New/Add SFFQ jj RemodelSF7— Garage/New/AddF
Valuation $ F
Material/Labor
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City State F-_
Zip F_ Telephoned --
APPLICANT'S NAME Last X y
First I —r, G4
Applicant's Address
Applicant's E-mail Address
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City I I U -� State L
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Zip tj Z /?S Z TelephoneF—
ARCHITECT/DESIGNER'S NAME Last
First F_ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephoned
ENGINEER'S NAME Last \ �( �`
1Engineer
First �L Lic. No.F—
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En ' ineersAddress
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Engineer'E-1 d
City State F
Zip F— TelephoneF_
CONTRACTOR'S NAME/COMPANY k'
Lic. No. '; _ 4 Class
Contractor's Address
Contractor's
Contractor's E-mail Address
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Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO. ze> zz> — Z
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 23'j2=o
USE ZONE ^_ DEVELOPMENT NO
PLAN CHECK FEES $