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HomeMy WebLinkAboutX2021-0432 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 6`�`WPo"a F- Comm'I JV Residential City of Newport Beach - Building Division X Zo l l - 9k3 t a NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL °<� , ,PBuilding F -'Grading F -Drainage P7"Elec F_Mech %Plum cu yd cut Cu yd Fill Project Address (Not mailing address) r Flood Fire F -"I Liq r Landslide F_N/A Floor Suite No S3_ CA -7A -L4 4 k 111 be, 9QV ot27_ t-40 , F Description of Work Use F Const Type �' - F— #Stories #Units (if Res) I a.. -..-. valuation $ Material/Labor � '. F5 � � r�+n/ce�u,�r-r_r�_'I-r� pttN r,a 'dV�,_athI r,, � ������_� . �1�� I,;� F) I, t e. ..._,_L.©rKP_PA-I Ste. RorLA t P.J C Rfye_; N114*1411 It 1,:�IJAVi New/Add SF Remodel SF Garage/New/Add a/New/A g dd T.) � _ �, OWNER'S NAME Last �Na f,3F) First `4 Owner's Address Owner's E-mail Address J' I _C,A-1A t , t. jE rt ', — 'tn r �_FC 4 i °t i -- ----- rA l icy City I t 111 i'.� " (. j' �.1. �„ T" S� F State r I 1 Zip �� wW a Telephones l'? APPLICANT'S NAME Last N1 �)l /, (�( �G% First Ff „ J Applicant's Address Applicant's E-mail Address City 1-� �; States V o, I .'r. Zip Telephone t.�t'�"—�t—` C- I � �a lac alb _i.. ARCHITECT/DESIGNER'S, NAME Last 1, First Lic. No. Architect/Designees Address Architeet/Designer's E-mail Address City State r Zip Telephonel— ENGINEER'S NAME Last 'First F Lic. No.F--' Engineer's Address Engineer's E-mail Address City �. State F_ Zip Telephone CONTRACTOR'S NAME/COMPANY vnC_ffl j'/t(r� � ) / n/tA Lic. No. F716 j i) Class Contractor's Address Contractor's E-mail Address I ; Ct r 1.1' \i F . _r /� �y? .1. IIT - State '� ZipTelephone , -. . SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $