HomeMy WebLinkAboutX2020-2686 - Permit ApplicationL_ Print Form Ja Worksheet for Combo Building & Solar Permit Application
F Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(A —wilding r Grading j—Drainage r Elec F_ Mech r Plum CuvdCut CuvdFill
Project Address (Not mailing address) r Flood F_ Fire F_ Liq r Landslide FN/A Floor Suite No
Description of Work /
Use ConstType
# StoriesFT # Units (if Res)[
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New/Add SFF Remodel SF� Garage/New/Add z
9
Valuation $ Z5c coo
Material/Labor
OWNER'S NAME Last �vNL// IN First Cater" �ni
Owner's Owner's E-mail Address
nAddress
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City State �� Zip Telephone
APPLICANT'SNAME Last �G���91V First
Applicant's Address Applicant's E-mail Address
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City F_ State Zip F_ Telephoned
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ARCHITECT/DESIGNER's NAME Last �/ First {?,e vC /� Lic. No.
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ArchitecNDesigner's Address Architect/Designeerr's E-mail Address
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City + State F__ Zip Telephone 7i f 747� �77�
ENGINEER'S NAME Last � L First M,Lic. No.
Engineers Address Engineer's E-mail Address
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City ��� .-State Zip%l Telephone
7
CONTRACTOR'S NAME/COMPANY Lic. No. F Class
Contractor's Address Contractor's E-mail Address
City State Zip Telephoned
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SETBACKS REAR �'J �FTBACKS FRONT `� / PERMIT NO.
SETBACKS LEFT / SETBACKS RIGHT iL / PLAN CHECK NO. Zt z1 7
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USE ZONE _ DEVELOPMENT NO PLAN CHECK FEES $