HomeMy WebLinkAboutX2020-1135 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F- Comm'] F- Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building F_GradingF-Drainage F-Elec F-Mech
F-PlumCuvdCut � cuvdFill
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Project Address (Not mailing address) C Flood
F- Fire F— Liq F- Landslide _N/A Floor Suite No
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Description of Work
Use F—ConstType F
# Stories]` # Units (if Res)F
Valuation $ �V
Material/Labor �`NNh� �3 I /
New/Add SFF Remodel SF! �
Z (�, S
arage/New/Add F
OWNER'S NAME cn��vA1
Last FROM O.•�
1 V
!
First 1 (�f1 (
IAddress
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Owners Address
Owner's E-mail
4 S)umk,��sZw,�� G�
City _ N (Z - , State
Zip 192,�a Telephone, -7/ 6 S 9
APPLICANT'S NAME Last v S� I � �'�
First �s'f,,�
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Applicant's Address
Applicants E-mail Address
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j NG,s,rw1l4 �6ox. N
City I f� (� �Al� State ( GIT
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ZiP ;�Z%L,).- Telephone �/4
ARCHITECT/DESIGNER'S NAME Last
First I Lic. No.
Architect/Designer's Address
Architect/Designers E-mail Address
City State F
Zip F Telephone,
ENGINEER'S NAME Last I X
First I A U (f Lic. No.j S L
Engineer's Address
Engineers E-mail Address
ct ook4. Not._ow PR '0 4S"
City IJI'W � A.� ,NR State 1 GA
Zip I. %L ) Telephone��) j, , `- 0 �T v
CONTRACTOR'SNAMEICOMPANY , rvc,tlS NSA Lic. No. Class i�
Contractors Address
Contractors E-mail Address
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City S(Ar t (I Alva State �—
Zip �,Z��tj� Telephone! �/�(Q /
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 4
USF 70NF nova, nonnon,T Kin
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