HomeMy WebLinkAboutX2020-2739 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 11
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r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL J
F-Building F Grading F-Drainage F_ Elec F_Mech r Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) r- Flood F_ Fire F_ Liq F_ Landslide F_N/AFloor Suite No
20S C-A5T Rm FllZoNTr
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Description of Work
���� 1-� Use F—ConstType
15 i FLIZ I "rtoode( of por:cµ, 9tJT'&1j
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#Units (if Res)
2N0 fl �1 liXtb?'&,�L3GDQoos., Yn•f3pTL1•j3F1]Rmry+i2i86e,2oow,3
tAuNVRY�tories�
, GA
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New/Add SF F Remodel SF Z;T
Valuation $
Garage/New/Add F_ Material/Labor 4-6
OWNER'S NAME Last S/ F7 7)
First
Owner's Address _
Owner's E-mail Address
2-05 FA sT ►3A Y F4o rvT
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City j i$w ?ot j-�,CAcVt State c Zip 426G 2 Telephone 9 (� q LM 922
APPLICANT'S NAME Last A
First Y A SsEk
Applicant's Address
Applicant's E-mail Address
16b1 LEr° -
y&M er JL TO 5- AL
City SAN?A ANA � State CA
Zip 912i01 Telephone 14,j p,8z h g 35
ARCHITECT/DESIGNER'S NAME Last I SALCM First Y',Z Lic. No. �
Architect/Designer's Address
Architect/Designer's E-mail Address
City 1 '5407-A A iu A State I GA
ZIP 9 2.'7 n 1 Telephone 9 _-j 2, i g rj 8 4-2
ENGINEER'S NAME Last SAL£
First %SSG-/Z Lic. No. 74
Engineer's Address
Engineer's E-mail Address
5AY1 a A S A i2ctl r i Ec.-r
City State F_
Zip F— Telephoned \
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CONTRACTOR'S NAME/COMPANY G F,hY V tk<t n, d.2_ Lic. No. F3tt5_=� Class (ram
Contractor's Address
Contractor's E-mail Address .Frc. K,6< JIS k •- ,�-,n�
736 SZyo.Sr 413
City State [ j}
Zip Telephoned_
Z3
SETBACKS REAR SETBACKS FRONT
PERMIT NO. �C.f (5)0-0-- t-Y 1-5
SETBACKS LEFT SETBACKS RIGHT
3 PLAN CHECK NO./Gig
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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