HomeMy WebLinkAboutX2021-2861 - Permit Application (2)Print Form Worksheet for Combo Building & Solar PermUO2
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F_ Comm'I r Residential City of Newport Beach - Building �� 2 gNOTE: PLAN CHECK FEES DUE AT TIME OF SUBMI
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Project Address1(1N,otQmailing F Flood F_ Fire [— Liq r Landslide �N/A Floor Suite No
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Description of Work
Use Const Type ��
# Stories # Units (if Res)
Valuation $
Material/Labor.
New/Add SF Remodel SF Garage/New/Add
OWNER'S NAME Last
First
Owner's Address
Owner's E-mail Address
City
State Zip Telephoned
APPLICANT'S NAME Last
MAL)qcf/L First
Applicants A_ddress
Applicant's E-m�Ca
fiil tAd-dress
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City _ „{� ,��( c,...
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_.' State —, Zip , TelephoneF�gq (M--qq64
ARCHITECT/D SIGNER'S NAME
Last YK��$ Q First F Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State F Zip �— Telephone[
ENGINEER'S NAME Last
KA First Lic. No.[—
Engineer's Address
Engineer's E-mail Address
City
State F_ Zip F Telephoned
CONTRACTOR'S NAMEICOMPANY
h . � T � tic. No. j'-3_5�--Class I
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Contractor's Address
Contractor's E-mail Address
738 sr
city 5t.,
State I c-P�. Zip � Telephone 4-954•411li0o
SETBACKS REAR
'
.SETBACKS FRONT PERMIT NO. 'boVl_
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $