HomeMy WebLinkAboutX2021-0140 - Permit ApplicationWorksh-est for Building Combo Permit Application
t Gim1 Cj ResidentialCity of Newport Beach -,Building Division
iv NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
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roject Address (Not rn&�1111n9 address)/ 111 --JJ FLh—r J Suits No
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# Units (if'ResC]
New/Add SFRemodel SF� GaregelNaw/Add L
OWNER'S NAME Last[ :� Co l First
Alma �Z-� /OPrO
Owner's Address Owners E -mal Address
City(�f�/�j --� State Zip Lf TalapMone=r�0�" 1
APPLICANTS NAME ' . . Lest
Applicant's Address
City State F
ARCHITECT/DESIGNER'S NAMti
Address
City
First
Applicant's E -mal Address
Zip
Last _--_� Flat Uc. No.
Aruhtlect/Deslgnel's E -mal Addrese
State Zip L.—�f9 Talspimna� ' I
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ENGINEER'S NAME Last— � Flrst�� Uc No.��
Engineer s Address Engineers E-msli Address
City. �— Stets C� Zip �� TalephoneL� .
CONTRACTOR'S WINIENOMPANY �j _ Uc No. Cless�
Contractor's Address Contractor's E -mal Address .
City �— Slate ZIp Telephone .
ENERGY P/C FEE $ FIRE P/C FEE PERMIT NO. C
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GRADING PIC FEE $ PLANNING PIC FEE $ PLAN CHECK NO.
PLAN CHECK FEE $
ELEGIPLUIvVIvIECH P/C FEE $ _ . �-