HomeMy WebLinkAboutX2020-2038 - Permit Application (2)Print Form Worksheet for Combo Building & Solar Permit Application
(- Comm'I Residential City of Newport Beach - Building Division 5
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building F_ Grading F-Drainage F Elec r Mech
r Plum cu Yd cuts Cu Yd Fill
Project Address (Not mailing address) r Flood
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Description of Work
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Valuation$ I'q!
Material/Labor
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OWNER'S NAME Last �AXY-�NR,v
First �:_om ,l
Owner's Address
Owner's E-mail Address
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Zip q��n0 Telephone
APPLICANTS NAME Last '7rf 't First
Applicant's Address
Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAME Last G First57/q Lic. No. 2 33 y
Architect/Designees Address
Architect/Designer's E-mail Address
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ENGINEER'S NAME Last SK U-PL}12SK/
First J_44 z ,y/ Lic. No. G 6771Z
Eng'�iineer's Address
Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY Lic No. �jj10 I Class
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Contractor's Address
Contractors E-mail Address
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Zip gZ66 8 Telephone 090 7g1y 1_((,-
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SETBACKS REAR SETBACKS FRONT
PERMIT NO. VV •
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. I ,�
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $