HomeMy WebLinkAboutX2021-1555 - Permit ApplicationPrint Farm Worksheet for Combo Building&`Solar Permit Application C&P
Comm'I r Residential City of Newport Beach - Building Divisionry (q��NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT !Z !
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/Project
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Description of Work
UseFi5 ConstType
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IF StoriesFT # Units (if Res)F
Valuation $ j e UOD� O a
Material/Labor L u e
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OWNER'S NAME Last �g cxH p First
Owner's Address Owner's E-mail Address
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APPLICANT'S NAME---
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Applicants Address Applicants E-mail Address
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ARCHITECT/DESIGNER'S NAME LastFirst Lic, No, - d Z
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Architect/Designer's Address Architect/Designer's E-mail Address
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ENGINEER'S NAME Last sr, , ^ First Lic. No
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Engi eees A dress Engineer's E-mail Address
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CONTRACTOR'S NAME/COMPANY /VU(� Lic. No. F,R a 0Class
Contractor's AddressContractor's E-mail Address
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SETBACKS REAR SETBACKS FRONT PERMIT NO. nn �,
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. MAY-