HomeMy WebLinkAboutX2021-3054 - Permit ApplicationPrini Form Wor"fiqet for Combo Building & Solar Permit Application ohm
F- Comm'I F_. Residential
x ) City of Newport Beach - Building Division -
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NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIUO 4
F -,Building F_ GradingF�Menage F_ Elec FMech F- Plum cu yd cutF Cu Yd Fill
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Project Address (Not mailing address) F_ Flood F- Fire F-, Liq J_ Landslide F_N/A Floor Suite No
Description of Work
UseF Const Type
StorIesF_ # Units (if Res)F_
Valuation $
Material/Labor
New/Add SFF7--7 Remodel SFF77777Garage/New/Add F7777
OWNER'S NAME Last J/ First
Owners Address Owner's E-mail Address
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F_ Telephone
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APPLICANT'S NAME Last First
Applicant's Address Applicant's E-mail Address
City State zip Telephone
r -z, 510 Vim os -6
ARCH; rECT/DESIGNER'S NAME LastFirst Lic. No.
Arc�'ect/Designer's Address Architect/Designer's E-mail Address
City State F_ Zip Telephone
ENGINEER'S NAME Last First Lic. Nofz�s_)c_zrj� -1
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Engineer's Address Engineer's E-mail Address
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city State zip Telephone
CONTRACTORS NAME/COMPANY V&L 11eCAJ-- Lic. No. ,1 37 _q37 L -, Class
Contractors Address Contractor's E-mail Address
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City State FcA Zip Telephone[
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK No. Will"
USE ZONE DEVELOPMENT NCt PLAN CHECK FEES $ -IT