HomeMy WebLinkAboutRev21-0296 - Permit ApplicationLA
_Print Form Zksheet for ombo Building &Solar Permit Application
Comm'I Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL c<,.oa,..>
rBuilding F_Grading
F -Drainage rElec F_Mech ""Plum Cu Cut Cu Yd Fill
Project Ai{d�j�pfdress (Not mailing address) C Flood r Fire r Liq Landslide [N/A Floor Suite No
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Description W rlk
a �9" Use F Const TypeA
1l # Stories I" #Units (if Res
New/Add SFF —
Remodel SF
Valuation $
Garage/New/Addr_- Material/Labor
OWNER'S NAME Last -"-" -_
First
Owner's Address
Owner's E-mail Address
City
State zipTelephone
APPLICANT'S NAME �
First
Applicant's Address
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Applicant's E-mail Aress j
F.
City
tat
Zip ( Telephone a
ARCHITECT/DESIGNER'S NAP*Last
First Lic. No. r----
ArchitecUDesignees Address
Architect/Designe� E-mail Address
City ��
State F_
Zip I-._ Telephon ;, r
ENGINEER'S NAME
Last
First F - Lic. No.
.Engineer's Address
Engineer's E-mail Address
City
State--
Zip F Telephoned`
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CONTRACTOR'S NAME/COMPANY
Lic. No. 7 Class
Contraacctor's Address
Contractor's E-mail Address
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City _-,r ` 'J,
State
Zip �$ �`i. Telephone 71-1 7-77-'514W
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SETBACKSREAR
SETBACKS FRONT
PERMIT NO
SETBACKS LEFT /"""�,
SETBACKS RIGHT
PLAN CHECK"NO.? f
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $