HomeMy WebLinkAboutX2021-1799 - Permit Applicationh,-� x 2ovi - V IVB -I
Print Form_: Worksheet for Comb-0--B-Lr_11_cr,_n-gWSo1ar Permit Application
City of Newport Beach - Building Division'
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Project Address (Not mailing address) Flood ❑ Fire ❑ Liq Landslide [N/A Floor Suite No
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Des ripton of Work
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OWNER'S NAME Last 272 First
Owner's Address Owner's E-mail Address - -
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State Zip Telephone— -_
City
APPLICANT'S NAME Last_ First
Applicant's E-mail Address
Applicants Address
cityState F Zip J Telephoned
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Last First y '— Lic.No.
ARCHITECT/DESIGNER'S NAME L�;_
- Architect/DesignersE-mail Address
Architect/Designer'sAddress
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First I. Lic. No. b _1 f
ENGINEER'S NAME Last J
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Engineer's Address
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Lic. No. j e I-] ClassI
CONTRACTOR'S NAME/COMPANY lJ _ _ 1
Contractors E-mail Address
Contractor's Address
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Ci[ State � : ZiP `� ` Telephone
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SETBACKS FRONT PERMIT NO. '.
SETBACKS REAR PLAN CHECK NO.
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SETBACKS LEFT SETBACKS RIGHT �--
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DEVELOPMENT NO PLAN CHECK FEES $. �—