HomeMy WebLinkAboutx2021-2886 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
[—Comm'I F_ Residential City of Newport Beach Building Division XZOZI
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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[-Building F_Grading Drainage [ElecrMech 'Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood r Fire f- Liq r Landslide 1 -N/A Floor Suite No
Description of Work_,__7 L Use F Const Type
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a # Stories # Units (if Res)1
Valuation $ p
New/Add SFRemodel SF� Garage/New/Add F Material/Labor ` f
OWNER'S NAME LastPo(:)!Z-) First
Owner's Address Owner's E-mail Address
City �C� t, 1 State G!%L ZipK— Telephone
APPLICANT'S NAME Last ` First
Applicant's Address Applicant's E-mail Address
11
Gl�b./2-- �V V�kA- - 6- V1,aS, JV C, e -✓Kai . [;C)✓✓\
City Statet Zip q2-5 . Telephone _77,a)17635
ARCHITECT/DESIGNER'S NAME Last
First � Lic. No. F7777 Address Architect/Designer s E-mail Address
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City �— State �- Zip s Telephone—
ENGINEER'S NAME Last First Lic. No.[—
Engineer's Address Engineer's E-mail Address
City State F Zip 1 Telephoned
CONTRACTOR'S NAME/COMPANYI C� � / - lV� Lic. No. 6�i(2 (� Class
Contractor's Address Contractor's E-mail Address
LZ C Ike c�s�w, tk� eLJ1j0� .CCILLA
City I CDIZ AC, Ojt v A,_ State tl Zip 7 TelephoneFfLkci
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT R PLAN CHECK NO.
USE ZONE DEVELOPMENT NO V W $