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HomeMy WebLinkAboutX2021-3124 - Permit ApplicationWorksheet for Combo Building & Solar Permi plica io o Wire F_ Comm'I F—, Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITT ( oaa f -Building Grading f—Drainage ['Flet —MechPlum F_ Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) F Flood f—, Fire F, Liq F Landslide F7.N/A Floor Suite No 2950!5' Description of Work Use Const Type # Stories;F_ # Units (if Res)[ — -- - --------- Valuation' New/Add SFF____Remodel SFF___ --Garage/New/Add Material/Labor v l,06 - OWNER'S NAME Last I PAikAIL- First Owner's Address LO!(_16655- N© YES Avu- city VINE Owner's E-mail Address State Zip APPLICANT'S NAME Last I z�/I-/'l (:—�_ Applicants Address City State Applicant's E-mail Address Zip Telephone ARCHITECT/DESIGNER'S NAME Last 514 ee:/Oc, First Architect/Designer's Address City State '2 d' Lic. No.FC /`7p60 Architect/Designer's E-mail Address ZIP Telephone lr4 _7 7� 11 ENGINEER'S NAME LastF77777 First Lic. No. Engineer's Address City State [7777 Engineer's E-mail Address Zip Telephone[ CONTRACTOR'S NAME/COMPANY Lic. No. Class Contractor's Address Contractor's E-mail Address City State Zip Telephone SETBACKS REAR SETBACKS FRONT PERMIT NO. 0 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $