HomeMy WebLinkAboutX2021-3014 - Permit Application1 ®sneet�ror t, omoo t3miaing & solar vermit Application o�cwrori
F_ Comm'I F_ Residential
City of Newport Beach - Building Division 9
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL G
Building F- Grading f—Drainage rElec F_MechPlum cuvdCuts Cu Yd Fill s
Project Address (Not mailing address) C Flood f- Fire �, Liq r Landslide [N/A Floor Suite No
Description of Work Use Const Type F_
2 N► a ; Ree lei ce
# Stories # Units (if Res)
- Valuation $ //
New/Add SF Remodel SF 2� Garage/New/Add F Material/Labor (O !00
-, _ r
OWNER'S NAME Last First ^ ^
Owner's Address Owner's E-mail Address
l(o 2-7 1eRor/--
_.
City I )end.; State zip q 2 Telephones
APPLICANT'S NAME Last First
-- _
Applicant's Address Applicant's E mail Address
City State Zip sTelephone--
ARCHITECT/DESIGNER'S NAME Last FirstF77777 Lic. No F-
- -- -
Architect/Designer's Address Architect/Designer's E-mail Address
City State �— Zip Telephoner
ENGINEER'S NAME Last First Lic. No.1
Engineer's Address Engine E-mail Address
City State F Zip Telephone
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor' E mail Address
City State �— Zip �— Telepho
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $