HomeMy WebLinkAboutX2021-3064 - Permit ApplicationLprintForik Worksheet for Combo Building & Solar Permit Application
F Comm" E Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
.,Building F- Grading F -Drainage F,,-,Elec F Mech Plum cu Yd cut
F Cu Yd Fill
Project Address (Not mailing address) f— Flood r Fire f—, Liq F- Landslide F. -N/A Floor Suite No
1-bic F
Description of Work
1 tA k� -, &,/ &
New/Add SFF---------.----...-.
OWNER'S NAME
Owner's Address
Use f—SITiNT"
1 Const Type M,
-Z, ----- --- I , - ---
# -3
Stories[— # Units (if Res)F—
L
-56 uation $
I Z 7 5 Garage/New/Add Materlal/Laborl
Remodel SF '10
I Val
Last
First
Owner's E-mail Address
City state zip Fq-�Z -5
TelephoneF
APPLICANT'S NAME Last
Applicants Address
GV-\ State -C4
City
First I t;
Applicant's E-mail Address
Zip Fqwl Telephone
IT 4
ARCHITECTIDESIGNER'S NAME Last First F— Lic. No. 17—
Architect/Designer's Address
City State
Architect/Designer's E-mail Address
Zip F Telephone[______
ENGINEER'S NAME Last First 7- Lic. No.F--
Engineer's Address
City State
Engineer's E-mail Address
Zip F—-7 Telephoned7
CONTRACTOR'S NAME/COMPANY Lic. No.Class
F63 - 6 1 � ; 3
Contractor's Address Contractor's E-mail Address
City State zip TelephoneF
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO, 17 (W (9 7, =