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HomeMy WebLinkAboutX2021-3236 - Permit Application1 _PrntForm j Worksheet for Combo Building &Solar ISS1, i /�pp+ica F Comm" Residential City of Newport Beach - Building DivINOTE: PLAN CHECK FEES DUE AT TIME OF Building [ Grading Drainage [;Elec [ Mech F Plum Cu Yd Cut( Cu Yd Fill Project Address (Not mailing address) 1- Flood r- Fire r-, Liq r Landslide -,.N/A Floor Suite No r�rc-----c- / Gcr4iu�} O ✓�wr� CA - of Work PO4"<D rr Gtg OAOAtL.ti 14 v— V -- New/Add SF�— Remodel SFGarage/New/Add OWNER'S NAME Last Owner's Address City �— State APPLICANT'S NAME Last Applicant's Address City— _— — — State First Owner's E-mail Address Z I p First Use Const Type F i, # StoriesF– # Units (if Res) Valuation $ Material/Labor Applicant's E-mail Address Zip F Telephone— --- ----- ARCHITECT/DESIGNER'S NAME Last First F Lic. No. �— ArchitectIDesigners Address City State Architect/Designers �— E-mail Address Zip F TelephoneF— ENGINEER'S NAME Last First Lic. No.�— Engineer's Address City State Engineers E-mail Address – — — --- -------- zip - Zip �- Telephoned—: CONTRACTOR'S NAME/COMPANY Lt�,f}ut G�fs y f4�'t�c'3 Lic. No. j ClassFs Contractor's Address loco�n,l S } 2Zc� City �{/crcuPU State �— SETBACKS REAR SETBACKS LEFT SETBACKS FRONT SETBACKS RIGHT Contractor's E-mail Address �/Itic��iell v --ow Zip © Telephone cftf. _,' f 7-GL?3 PERMIT NO^"' PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $