HomeMy WebLinkAboutPV2021-074 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application
r- Comm'l r-, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F',,Building [,Grading r -,Drainage K,,rE[ec r-;, Mech F_` Plum CuYdCut[77 CuYdFill
Project Address (Not mailing address) r7j, Flood f- Fire rLiq r- Landslide _N/A Floor Suite No
Description of Work
Use Const Type F_
k: +G 6n,-,+41Atz;A f)-+' PV 5blar
#Wll�" VAte-i
# Storleswq 4 Units (if Res
2.
Valuation $ F
Material/Labor
New/Add SFF77-777 Remodel SFr
Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owners E-mail Address
F_
City 14�proAg Det _KoLr State Zip Telephone[T4�; Z%5-5321-5321
F9 �ZT
APPLICANT'S NAME Lost
First mjBA)
Applicant's Address
Applicants E-mail Address
city F—g I -e State F
zipF5_z_iE_i` Telephone F7 h &4:4,1
ARCHITECT/DESIGNER'S NAME Last First Lic. No.
Architect/Designees Address
F_
Architect/Designer's E-mail Address
City State
Zip Telephone
ENGINEER'S NAME Last F Lic. No.
First
Engine' or's Address
Engineere. (cry
City StateF777
Telephone
Zipe— F
CONTRACTOR'S NAME/COMPANY E,No__
Lic. No. [445Z-40,1 Class
Contractors Address
Contractors E-mail Address
Arl,
City State Fc�.T
Zip Telephone F7/4
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USEZONE DEVELOPMENT NO
PLAN CHECK FEES $