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HomeMy WebLinkAboutX2021-3184 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application (- Comm'I r Residential City of Newport Beach -Building DivisionF 61cu y NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI A [Building [Grading Drainage FElec j-"'Mech Plum CuvdcutF Cu Yd Fill Project Address (Not mailing address) C Flood I- Fire F-, Liq I- Landslide F -_.N/A Floor Suite No I�-- New/Add SF OWNER'S NAME Last Owner's Address First Owner's E-mail Address City ,C!5�t State IC -0,V Zip �� Telephon /3© Use F7 Const Type �I # StoriesF_ # Units (if Res) Valuation $ Material/Labor APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address 6'ZLlcr St-Svt�e_3. City StateQ Zipr. q�/�6' Telephon ARCHITECT/DESIGNER'S NAME Last First �— __.-._ Lic. No.�— Architect/Designer's Address Architect/Designer's E-mail Address City State �— Zip �— Telephone ENGINEER'S NAME Last First F Lic. No. Engineers Address Engineer's E-mail Address City State r Zip I Telephone�— 49 CONTRACTOR'S NAME/COMPANY Lic. No. fY�� Class Contractor's Address Contractors �E-mail Address City / �G� Afe 71 State Zip � Z� Tale hon SETBACKS REAR SETBACKS LEFT USE ZONE SETBACKS FRONT PERMIT NO. SETBACKS RIGHT PLAN CHECK NO. DEVELOPMENT NO VC16 19 -A. CHECK FEES $