HomeMy WebLinkAboutX2020-2038 - Permit ApplicationPrint Form ) Worksheet for Combo Building & Solar Permit Application
j Comm'I ( Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building j- Grading rDrainage F Elec r Mech
F Plum CuvdCut CuvdFill F
Project Address (Not mailing address) r Flood F_ Fire F_ Liq j- Landslide rN/A Floor Suite No
r9
F_ F_
2s0 )3kiv Sl, Nov' DjZiI5<--ACli "
77-&60
Description of Work &,; I 4 -E61 PAA1-
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Use r— ConstType F_
/ FT rus4K ff %
# Stories # Units (if Res)F—
Valuation $ f
Material/Labor 1 c$C) C+ -0-
r
New/Add SF Remodel SF F— Garage/New/Add F—
OWNER'S NAME Last � Zk /,d�N
First Ko m, ie.A-)
Owner's Address
Owner's E-mail Address
City nliEicTP—og-T f3E,4-1f State GA
Zip 7Z466' TelephoneF
APPLICANT'S NAME Last T lZ�ks
First F— �
P
Applicant's Address
Applicant's E-mail Address
I'%0 19 u}+ t c sT, su rcr- j 2d
Pc-J Cd- j -lG /} 1, /y
City 1 avt7°)z7��`�, State e— A
Zip 7'Z�� eD Telephone `7V7 $51- AM(5-
ARCHITECT/DESIGNER'S NAME � 3 y
Last , FirstlC/tfLtS7/qN Lic. No. FL23
Architect/Designees Address
ArchitecUDesigner's E-mail Address
4101 QA�l (- sT, S'lc
F--0A>@CJ4-/&/J7. AIC T
City 114t;- polZ7 B�_-Ae_/i State C.g
Zip 2Q'6v Telephone Qyy grj- ? S
/ -e� `�
ENGINEER'S NAME Last Sj«I�LAjZ sJCI
First,f,j Lic. No.1 G 67 7%2-.
Engineer's Address
Engineer's E-mail Address
y7sl utj: p/c. pjzlvE
JSO.J12-3J
City yaai/xI;Tvx,,, /3£fuH State F C.A
Zip I 9z6r1& Telephone 7tc�7.z.
CONTRACTOR'S NAME/COMPANY �K l ov
!
Lic. No. W1,057 ClassF
Contractor's Address
Contractor's E-mail Address
pFh/L
1 I-r(y �A�jo ii�lrl�, cam.
City "t—IrefZ. � AcHc State
Zip 92tC(vQ Telephone�'fc% 79� 9S jam{
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1 lD 7— 7,070
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $