HomeMy WebLinkAboutX2021-1715 - Permit Application•■ter norrCGC rvr vomoo Building & Solar Permit Application �s-=q
j� Comm I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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Garage/New/Add Valuation a
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OWNER'S NAME Last
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Owner's Address _
Owner's E-mail Address
City
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APPLICANTS NAME
Last
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Applicant'sAddress.
Q ,� J Applicant's E-mail Address
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ARCHITECT/DESIGNER'S NAM_10018 Zc r y r
Last .. _ FirstF�__-_
Architect/Designer's.Address Lic: No. r----
ArchitecUDesigner's E-mail Address
City
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ENGINEER'S NAME LastFirst
Fr� ������������'`� Lic. No.r___-
Engineer's Address -
Engineer's E-mail Address
City
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Zip Telephone
CONTRACTOR'S NAME/COMPANY t 5 P r
V = G /i ? P lc%I C Lic. No. ail —�,$-r ClassContractor's Address _
Contractor's E-mail Address
. City -e::, : (tJefy_�k StateZip /+ , I�`Cy
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SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT PERMIT NO.
SETBACKS RIGHT
PLAN CHECK NO,
USEQONE DEVELOPMENT NO
PLAN CHECK FEES $ 8
0
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