HomeMy WebLinkAboutX2020-0227 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
LG.�Comm'I Fi4esidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Pguilding ❑Grading E,Drainage EElec EMech C, Plum Cu Yd Cut77 Cu Yd Fill F71
Project Address (Not mailing address) C Flood E Fire r Liq ❑ Landslide [N/A Floor Suite No
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Description of Work t1{1 -7W/y Qq/ %�S29U+TO.N
���/Us ConstType
Zira✓t i40
W-/10
6 AW A # toriesC # Units (if Res)[N
11
Eti ,P�o �tiuu6s, /�/3 rvsa�
Valuation $ 2
New/Add SFF7 — R eI SF Garage/New/Add Material/Labor 71AV
OWNER'S NAME Last
First
Owner's Address Owner's E-mail Address
City State � Zip F1 TelephoneF-1
APPLICANT'S NAME Last I �_fl—OA X
Applicant's Address
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City t!�2/tG 4A ISLA.4, State
First
Applicant's E-mail Address
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Zip �? fi Telephone ^ tiP>t57-t7i5- jI
ARCHITECT/DESIGNER'S NAME /����
Last ���//��� ;First /—�+iva i Lic. Np.
Architect/Designer's Address Architect/Designer's E-mail Address `^—F'--
i
City State Zip F Telephone
ENGINEER'S NAME Last _ First Lic. No.�,
Engineer's Address
i
City _ ! State �-
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City State
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT
SETBACKS RIGHT
Engineer's E-mail Address
Zip I Telephone
�,, Lic. No. Class
Contractor's E-mail Address
Zip �— Telephoned
PERMIT NO. D `yL
PLAN CHECK/No. Q.� / •�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $