HomeMy WebLinkAboutX2021-2788 - Permit Application (2)Print Form:'; ,� Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division X 24)2-j - Z7
F_ Comm'[ r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Building F_ Grading rDrainage rElec F_Meth F-, Plum cuvdcut Cu Yd Fill
Project Address (Not mailing address) F Flood r Fire F__ Liq r Landslide rN/A Floor Suite No
Description of Work Use s Const Type s
# Stories # Units (if Resf
Valuation $
New/AddSFF— Remodel SFF—Garage/New/Add Material/Labor
OWNER'S NAME Last First
Owner's Address Owner's E-mail Addres
City StateF— Zip Telephone�—
CONTRACTOR'S NAME/COMPANYLevlcv9- 6V1L�5 f G Lic.No. 1�, 71 Class
Contractor's Address Contractor's E-mail Address
IZ(,? A) TUSTI J ( o `{ l-W1G44(dUI LJ>e5R. CDWs,
city State GtL} Zip q Z �D7 Telephone 7 /{ 33 J I ,�' 4
REAR SETBACKS FRONT
SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEES $