HomeMy WebLinkAboutX2021-1060 - Permit ApplicationPrint Form °I Worksheet for Combo Building & Solar Permit Application
F_ Comm'I (- Residential City of Newport Beach - Building Division2k
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding [ Grading rDrainage r Elec
Project Address I
Description of Work
7 Mech F-PlumCu Yd Cut Cu Yd Fill
F- Flood r` Fire F- Liq F_ Landslide F_N/A Floor Suite No
�- Use F_ Const Type r
Stories #Units (if Res)
Valuation
New/Add SFF_- Remodel SFF_� Garage/New/Add F- Material/Laa
bor
OWNER'S NAME Last IC First I
Owner's Address Owner's E-mail Address
City 1..iGV.S�EC�c � State rG{ Zip qjZ;�r,0 Telephone-IiieA 4i-ft4_700
APPLICANT'S NAME Last SiL
Applicant's Address
First laJ
Applicant's E-mail Address
City--3�GJ r.rr.3, Fr lG V his State E,� Zip t�.�'i'? Telephone R�� .. i. !�-
ARCHITECT/DESIGNER'S NAME
Last
Architect/Designer's Address
City r_-._--- State
First. _ Lic. No.
Architect/Designer's E-mail Address
Zip F TelephoneF --.
ENGINEER'S NAME Last First ��_ -- Lic. No.F_�
Engineer's Address
City State
CONTRACTOR'S NAME/COMPANY
Contractor's Address
City Lj>- Vag M t Cil z L_
SETBACKS REAR
SETBACKS LEFT
USE ZONE
Engineer's E-mail Address
Zip �� Telephoner
t tit J rC o ty C-L1c.No. Class
Contractor's E-mail Address
~....,_� ev% T:�c c -1,.i SCr..I
State E Zip I:y:7�7 Telephone F`gZ44.4.13eA
SETBACKS FRONT
SETBACKS RIGHT
DEVELOPMENT NO
PERMIT NO.
PLAN CHECK N0.
PLAN CHECK FEES $
3