HomeMy WebLinkAboutX2020-3012 - Permit Application-Print Form Worksheet for Combo Building & Solar Permit Application
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F Comm'I '�( Residential City of Newport Beach - Building Division
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Xuilding Grading r"Drainage [—Elec FMech j—Plum Cu vd c]W Cu Yd FJI�
ProjectAddress (Not mailing address) [m Flood F- Fire j— Liq F Landslide FN/A Floor Suite No
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Description of Work
Use ConstType�
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# Stories[ —#Units (if Res)r—
Valuation $
Material/Labor
New/Add SF 3 CL� Remodel SFr—
- _ Garage/New/Add _
OWNER'S NAME Last %/hi First
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Owner's Address �koKE - /t i.�rR�l ^r KG( <v, —0/ -
Owner's E-mail Address
City lvwpo - State Zip ��o _ Telephone__.. -2-7__-
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APPLICANT'S NAME Last rJJ/7, An pl E
First
Applicant's Address
Applicant's E-mail Address
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City D _ A p State FrA-
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V l Zip Telephone 9 16'?, _
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ARCHITECT//(/DESIGNER'S NAME/
Last O Cy /�/
First ° Lic No. '.-�t�y
l i- I Y tl �Tu"i-
Architect/D�.esiigner's Address Architect/Designer's E-mail Address r
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City - State f -- Zip F Telephone[
ENGINEER'S NAME LastZ First I f6 Lic. No. ra�
Engineer's Address Engineer's E-mail Address
city State r— Zip �— Telephoned_
CONTRACTOR'S NAME/COMPANY hw� �L Lic No. 76py5-1 Class
Contractor's AddressAA , (j Contractor's E-mail Address
f u0rlx r (1`lpLVnor�
City ell upo�i- J.ufr�c� State cA Zip F ?� Go Telephone ," —
SETBACKS REA SETBACKS FRONT PERMIT NO. �nU IL —
SETBACKS
L T SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $