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HomeMy WebLinkAboutX2021-3289 - Permit Application (2)Print For Worksheet for Combo Building & Solar Permit Application oatEWPoR@ F_ Comm'I Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL v<„a,h.P rBuilding F_Grading rDrainage F_Elec rMech F- Plum CuvdCut F CuvdFill Project Address (Not mailing address) r Flood F_ Fire r Liq F_ Landslide F_N/A Floor Suite No r�J� r r^ Description of Work Use,,f�` Const Type F kaLVC,6br # Stories # Units (if Res)F, f' Valuation $ Material/Labor New/Add SFF—' Remodel SF � �� Garag e/New/AddF— OWNER'S NAME Last �. /1y_ 'tom\ First M t1 0 r -v` _- ----- Owners Address Owner's E-mail Address nG c�VCIA ccs XR_Z (j�_fk�o,�A"/- City I �e,, \-..( Pu C._ -T_- State Zip D Telephone,_ _2 -_ .._`feq_ APPLICANT'S NAME Last( First Applicant's Address Applicant's E-mail Address CL 0� ff City _ _�� ',, State—, `Telephone _tl Zip. F----,T- ARCHITECT/DESIGNER'S NAME � e Lic. No. Last r First C ��� Architect/Designer's Address 'tect/Designer's E-mail Address City State I LA-- Zip717 Telephone%-C/i`�.GC ENGINEER'S NAME Last n s �V First f n ^ I Lic. No f — Engineer's Address Engineer's E-mail Address City _ State F_ Zip-- Telephoned, CONTRACTOR'S NAME/COMPANY © / y` l� Lic No. F Class Contractor's Address Contractor's E-mail Address C G�M'C- a 5 _ �. 0lrS?,Je_ City _ - State F Zip �— TelephoneF SETBACKS REAR SETBACKS FRONT PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. get USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ r�