HomeMy WebLinkAboutX2021-0870 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
F- Comm'] r Residential City of Newport Beach - Building Division K20,2/ . 0 870
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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I -Building F_ Grading F -Drainage r Elec r Mech (- Plum Cu Yd cute— Cu Yd Fill e
Project (Not mailing address) F Flood r Fire r Liq F_ Landslide F_N/A Floor Suite No
Address
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6 DoDwq Q_ & F
Description of Work
Use F—ConstType F_
# Stories # Units (if Res)e
Valuation $
Material/Labor 4I t
New/Add SF �— Remodel SF Garage/New/Add F—
OWNER'S NAME Last 01 W ti kv_:� First FM t f[ -t
Owner's Address Owner's E-mail Address
City State �- Zip I il`VIT'A Telephone 9 4 I S, l,170
APPLICANT'S NAME Last 1 —, First 'nf U_s
Applicant's Address Applicant's E-mail Address
Zip
City '� (ate ( N C4 state �� �7 C7 S Telephone or, 4
ARCHITECT/DESIGNER'S NAME Last �— First F Lic. No. �—
Architect/Designees Address Architect/Designers E-mail Address
City State F Zip F Telephone--
ENGINEER'S NAME Last x I � C) First o t n N & Lic. No.
Engineer's Address Engineer's E-mail Address
IS'1.0 �
City SRN`, i �AVA State (� ZIPFR % 0 S Telephone ([� 662 0,!9_10
CONTRACTOR'S NAMElCOMPANY ,V&U_�Sa t {I� GCj4VS'-1 Lic. No. _,.'7 44 /) Class
Contractor's Address Contractors E-mail Address
I �:s 4 `�, 4�A+j'ao IV
City SCAN,_(6 NA State Zip . qa° ()S Telephone)
SETBACKS REAR SETBACKS FRONT PERMIT NO. y oI-I •17vtP
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. l�`bo5 1,7,'
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $