HomeMy WebLinkAboutX2020-2565 - Permit ApplicationPrint Form Worksheet for Combo Building $ Solar Permit Application (00i
F_ Comm'I r,"'Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Gilding Grading F-Drainage F_ Elec F_ Mech r Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing
address) F_ Flood I- Fire r Liq r Landslide F_N/A Floor Suite No
Description of Work
Use Z3 ConstType ' A�
# Stories #Units (if Res)
•p d f ��/'(Vl D ��
I
C�--> L� c.�,�� ✓ �-cT-lt/�/7
Valuation $
Material/Labor 3 0 10 0
ew/A SF I I. b Remodel SF I (� Garage/New/Add
OWNER'S NAME Last v 5- First ^\ dn6n t�
Owner's Address
Owner's E-mail Address
City
State Zip F Telephoned
APPLICANT'S NAME Last
S � First P„� -(
Applicant's Address
Applicant's E-mail Address
City t:�
State [EiiT Zip �!o Telephone
ARCHITECT/DESIGNER'S NAME
Last _\ First ����` Lic. No. C I I
rn , \ iZ
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State Zip F Telephone
ENGINEER'S NAME Last
p L , r First l �( Lic. No. +- ; U
Engineer's Address
Engineer's E-mail Address
City FT ��-k ,-�
State Zi 7�� p Telephone Yl G Z��7
CONTRACTOR'S NAME/COMPANY
Lic. No. FIFS188 Class
Contractor's Address
Contractor's E-mail Address
`10 S �t v/t 1
Vi �a�e��IJ S�lv�f �,n r✓^� //i�l - Co
City ���PD '(S
J- (
State F4 Zip �Z��t — Telephone gyJ(�'77IfiZ�
,t�C
SETBACKS REAR
SETBACKS FRONT PERMIT NO. 7O `
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $