HomeMy WebLinkAboutX2020-1994 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
r Comm'I 7 esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SIIRMITTAI
F_BuildingF_Grading (-Drainage F_Elec F_Mech
(-Plum CuvdCut F CuvdFill
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Project Address (Not mailing address) F_ Flood
I` Fire j" Liq F_ Landslide F_N/A Floor Suite No
02132 • UCb k VIvc . `� a F— �—
Description of Work
Use I— Const Type F_
E-4 T-A F
Howe
VIL
# StoriesF # Units (if Res)F_
New/AddSFI Remodel SF % Garage/New/Add
Valuation a
Material/Labor, / r�
OWNER'S NAME Last I l t n /�
a � !
/y �
First vV V
Owner's Address J
Owner's E-mail Address
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City N �-�yuf SS;��1-- State I�-
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ZiP �v Telephone !� 9 _ • � 7 / W
APPLICANT'S NAME Last t A�
First
Applicant's Address
Applicant's E-mail Address
City /ry,�.� 1l �e� State F r+ Zip `� y Telephone y _j
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ARCHIITTEECCTT//D(E(SAIGNER'S NAME Last 10 5e �t� � -
(� S�� First yr �_ Lic No. F_
Architect/Designer's Address
7_ ZS
Architect/Designer's E-mail Address
City State F— Zip 9� �Telephone� 137_ Q�
✓1_
ENGINEER'S NAME Last F3 c[J ES t-t-
—
First M�— L�AE� Lic. No..
Engineer's Address
3� F i T 5i�-- ,2a�
Engineer's E-mail Address
Mllnt��sh �r��
City /' p y�,�--,¢ � e_5 0E State Zip
Z 2- J Telephone y A'if _ 11` 42
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CONTRACTOR'S NAME/(COMPANY e, I n�
LicrNo(. I v q y/y`Klassl
(r / `~,'�' VVV
Contractor's Address
Contractor's E-mail Address
;31C r0a
City k State - Zip
Telephone i ''gy'\,(QQ�.
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. i
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ +