HomeMy WebLinkAboutX2020-1329 - Permit Application (3)NOTE: PHE KFEES DUAT TIME I ME OF XZ0Z 1325 o m
Print_Form Worksheet for Combo Building
E & Solar Permit A "°
rApplication EComm'I Residential
City
LAN Newport
O — u i
tJ
F-Building rGrading rDrainage rElec rMech rPlum Cu vd Cut Cu Yd FIIF
Project Address (Not mailing address) r Flood F_ Firer Liq r Landslide rN/A Floor Suite No
Description of Work
Use F—ConstType
# StoriesF # Units (if Res)F
Valuation $
Material/Labor
New/Add SF1 — Remodel SFF Garage/New/Add F_
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City State �— Zip Telephone[ —
APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State �— Zip — Telephoner
ARCHITECT/DESIGNER'S NAME Last First 1
Lic. No. ►V�\
Architect/Designees Address Architect/Designer's E-mail Address
City State �— Zip elephoneF_—
ENGINEER'S NAME Last First Lic. No.
Engineer's Address Engineer's mai dd s
City F State F Zip .� Telephone r ;
e
CONTRACTOR'S NAME/COMPANY �� re No. -D Class
Contractor's Address Contractors-E-mail
Contractor's E-mail Address
AddressJ
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U" ' c- L C-:VL. C;, hf1 1 J �P
City jlu State L, Zip Telephone CI Lj�
TBACKS REAR SETBACKS FRONT PERMIT NO.
SET KS LEFT SETBACKS RIGHT PLAN CHECK NO. U - Z02O
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $