HomeMy WebLinkAboutX2021-0851 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division t� Z) - D t S'
F Comm'I �(: Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
RBuilding r— Grading
{—Drainage ii( Elec 5f Mech F Plum cuydcutF-- Cu Yd Fill F—
Project Address (Not mailing address) r Flood r Fire f– Liq r Landslide (–N/ASuite No
118 28th Street
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Description of Work
-AF
If N
Use Const Type F—
1 c en rem e .
� #Units {if Res)
ON 49A
r,
New/AddSFF
Remodel5F118 Garage/New/Add )e&
l7
Valuation $ Paw
Material/Labor
OWNER'S NAME
Last i First isa
Owner's Address
Owners E-mail Address
1048 Irvine Ave. #738
City lNewport Beach
State FA Zip F2660 Telephone 949.874.6418
APPLICANT'S NAME
Last oolbert First Fraig
Applicant's Address
Applicants E-mail Address
622 Litter Drive
houses@gmail.com
City Huntington Beach
State CA Zip F2E49 Telephone 14.856.2605
ARCHITECT/DESIGNER'S NAME Lest oolbert First Fraig Lic. No.
ArchitecUDesigners Address
ArchitecNDesigners E-mail Address
622 Litter Drive
dhouses@gmail.com
City Huntington Beach
State ..A — Zip 2649 Telephone 14.856.2605
ENGINEER'S NAME
Last Ibert First rhan Lic. No. -61343
Engineers Address
Engineers E-mail Address
13104 Glen Ct.
City lChino Hills
State CA Zip F1709 Telephone 09.591.2468
CONTRACTOR'S NAME/COMPANY Lic. No. r Class F—
Contractors Address
Contractors E-mail Address
City......
State F— Zip F— Telephoned—
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 6
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $