HomeMy WebLinkAboutX2021-2084 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application EWPo
F_ Comm'IResidential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TINAE nc ci IRNAITTAI �^
Building r Grading
(-Drainage f-Elee ("Meth F Plum Cu Yd Cut Cu Yd Pill
Project Address (Not mailing address) f- Flood (` Fire F_ Liq r— Landslide f"N/A Floor` Suite No
Description of Work
Use s' Const Type F
( L'
`
rGK'
wcc L`
t
T t.� � �d `\@
# Stories- # Units (if Res)s
Valuation $
�(j (� 0
Material/Labor � J..�
J `
New/Add SF ---' Remodel SF "'
%'-<
Garage/New/Add a/New/Add r-
9
OWNER'S NAME
{�,E
Last �'t<''uy P�
- First n `>
Owner's Address
Owner's E-mail Address i
�1 v
City. n+\ _..
.. -... State ZIP -. -
-_ � � l't �/
bz Telehone �� S P J . oL
t
APPLICANT'S NAME
Last P {�
First C b
Applicant's Address
Applicant's E-mail Address
r
b�/j cc?3, G-
City is
State Lr. l,�.
/�
�j�(_7
.ZiP l � 61 Telephone
ARCHITECT.... /DESIGNER'S NAME Last F
First �— --(�
Lic. No. I
Architect/Designer's Address
;.. Architect/Designer's E-mail Address
city
i State �_.-._-....
zipaTelephgnes��
ENGINEER'S NAME
Last
First r---` ' --- Litt No.�—
Engineer's Address
Engineer's E_ mailAddress -,
City
State �-
Zip F_ Telephone—
CONTRACTOR'S NAME/COMPANY ')1'
Lic No. Class
Contractor's Address
Contractor's E-mail Address
City _.
- State-
Zip �� TelephoneF�NN -
SETBACKS REAR
SETBACKS FRONT
PERMIT NO..
SETBACKS. LEFT
SETBACKS RIGHT
PLAN. CHECK NO.�
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $