HomeMy WebLinkAboutX2021-0621 - Permit Application (2)Wbrksheeffor.Cornbo•Building & Solar Perrnifi
City of Newport Beach - Building Division I �//�/�� , U
�sidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMIJA
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t Address (Not mailing address) F7 Flood � Fire C Landslide �N/A Floor Suite No
Description of ork T� T" �/� i
Use .Const Type �^
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# StoriesF�# Units (if Res)
New/Add SF %' �J Remodel SFF—'
Valuation $s
Garage/New/Add �—' Material/Labor
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OWNER'S NAME Last First
S �-- -- -- ---- — -----
Ownees Address Address
Owner's E-mail Address
City — per, �/}?j6 f_ ( State Zip - c� Telephone �Y 3�C1L�
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APPLICANT S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City State F
Zip F7777 Telephone�—
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip [— Telephone1__—
ENGINEER'S NAME Last
First Lic. NoT—
Engineer's Address
Engineer's E-mail Address �— 38 c)
City �— State F
Zip I Telephone[—
CONTRACTOR'S NAME/COMPANY '— — Lic. No.�//�/ �/ /-
J r (;�n%P� 7Y�v/ Class
Contractor's Address
Contractor's E-mail Address
F�aa-e-�
City r c�1 - State L �`
Zip ��G y Telephone
SETBACKS REAR ( VfjdA SETBACKS FRONT PERMIT NO.. ' ��i�'
SETBACKS, LEFT SETBACKS RIGHT
0, Uoa PLAN CHECK 0. � tA31 � 2 I
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ .