HomeMy WebLinkAboutX2020-0912 - Permit Applicationcl��L)
Print Form Worksheet for Combo Building & Solar Permit Application
F_ Comm'I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Auilding F Grading rDrainage F- Elec F_ Mech
F- Plum Cu vd Cut rCu Yd Ail
Project Address (Not mailing address) F_ Flood
F- Fire f— Liq C" Landslide F_N/A Floor Suite No
Description of Work
Use 4L Const Type FV
# Stories7 #Units (if Res)
z ?---" 124:�_-ROV L A,41V I l,1r 1_7tV_
r6p(L"Ll
�4 r1r
Valuation$ _
Material/Labor I2 LioC+
New/Add SF 72 I Remodel SF �.f)C)Garage/New/Add rt�
OWNER'S NAME Last h (o_0-
First aAy:'=j
Owner's Address
Owner's E-mail Address
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City KA6LI �%'PJi �' i '�I State rA
Zip i Telephonel.-.....-..--.--..
APPLICANT'S NAME Last First ll(l"tl%EL.
Applicant's Address
Applicant's E-mail Address
State��
Zip 6�Z(r�i�L% Telephone ✓L.7,S� u.
ARCHITECT/DESIGNER'S NAME Last �—
First �/ Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State �—
Zip [ � Telephone[
ENGINEER'S NAME Last ir/r -wz-" f �J
First Lic No.� s�
Engineer's Address
Engineer's E-mail Address
City State F_�''
Zip f Z �40 Telephone 1 5-7;, Z. 7 - / •2- 7 �S
--
CONTRACTOR'SNAME/COMPANY etLWOL Lic No. Classy
Contractors Address
Contractor's E-mail Address
City I� State F—
Zip �� Telephone[ —
SETBACKS REAR SETBACKS FRONT
PERMIT NO. T,,Z0 C- U - (-)Cl I
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 06 Z - L p
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
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