HomeMy WebLinkAboutX2021-2942 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application QWPo"e
� City of Newport Beach - Building Division
F- Comm'I r,/Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
(-Building F_ Grading Drainage [_Elec F-•••.. Mech Plum Cu Yd Cut F_Cu Yd Fill F_
Project Address (Not mailing
address) [_ Flood F_ Fire F- Liq f-= Landslide CN/A Floor Suite No
F_ �-
231s 4 F^ILFftL(_ PL-
Description of Work
Use F—Const Type F_
# Stories #Units (if Res)
LaNDSCAX gaAws
wEic fqt—
Valuation
New/Add SF F_Remodel
SF F_Garage/New/Add F
$
Material/Labor
OWNER'S NAME Last
gpR rc cam( First
Owner's Address
Owner's E-mail Address
Z-3 15- F-WA(lcL DA -
_.
City I A.wJP41 STAQY _.
.....State _C;... ZiP TZ 6. ...Telephoner------ _....
APPLICANT'S NAME LastFW/Z(,
First I 44nrrw(
Applicant's Address
Applicant's E-mail Address
City N�wRdT-1 (3sAc{�
State I CA-... 4` .Zip. g7;6e Telephone j 1 -317$'2,114
ARCHITECT/DESIGNER'S NAME
Last p First F -----
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City I
State I Zip F TelephoneF_'
ENGINEER'S NAME Last
First [_' Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City
State I Zip r------_- Telephone
CONTRACTOR'S NAME/COMPANY
Lic. No. ,L(3 Class aZ
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Contractor's Address
Contractor's E-mail Address
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'�7J1 - .i7quni-, t e J9+," C1A-n,41 . -,
City I AIC'eAT Gf
State I -' — Zip _2 z_ 0 Telephone %rfi- 398 -Zi X77
SETBACKS REAR
SETBACKS FRONT PERMIT NO. __Jo
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. 27SSj e • 'L��
T
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $