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HomeMy WebLinkAboutX2021-3027 - Permit ApplicationWoykgNet for Combo Building & Solar Permit Application A F_ Comm'Ir Residential City of Newport Beach - Building Division x 1,c�J-4 - 3621 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL i I I l wilding F_Grading Drainage ['Elec Emech F_. Plum a,vdCut cuvdFill Project Address (Not mailing address) F__Flood r Fire r—,Liq F_ Landslide C,N/A Floor Suite No [aq-1 Description of Work Use Const Type hV �) # StoriesF_ # Units (if Res) Valuation New/Add SF q- • Remodel SF�— Garage/New/Add �—' Material/Labor r too �J OWNER'S NAME Last e +Y�� First /� - -- -- ._ L /__ .. -- ----- Owner's Address Owner's E-mail Address 0 City} j f J �/� - � �J_ ..tl.v"1 1 �G�i.Lj� State -i/�' — Zip l �e Telephone APPLICANT'S NAME Last First q Applicant's Address 'n Applicant's /E-mail Address /, -- --- - -�%/k _lvi� Vl��✓L-�1%/r°rl�f_C� a�Go©'0 — --- - _ ' City pp�� 11'' aa p 'A h State r� /— l/V1 Zip Telephone—S..I-L..--1.7�2-2-Z ARCHITECT/DESIGNER'S NAME Last First F_ Lic, No F— Architect/Designees Address Architect/Designer's E-mail Address City State F— Zip �— Telephone[ ENGINEER'S NAME Lasty�� //AA First [� jam`nNo Engineer's Address Engineer's E-mail Address ~ s_ -- ---- City U V' I UL V�C State C Zip Telephone � ; C -os-80 CONTRACTOR'S NAME/COMPANY T I / �i, p Lic. No. W 9 3 QWass -C-'p( ` -- Contractor's Address Contractors E-mail Address City `rU'n . State C/A Zip r� S Telephone �l -J SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO 'PLAN CHECK FEES $