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HomeMy WebLinkAboutX2021-3300 - Permit Application (2)Worksheet for Combo Building & Solar Permit Application ��'m r Comm'I r Residential City of Newport Beach -Building Division 7300 o NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ° ^`' 7 IK"ding r Grading rDrainage r Elec r! Mech r Plum Cu Yd Cut77 Cu Yd Fill F Project Address (Not mailing address) r Flood n Fire t Liq F! Landslide nN/A Floor Suite No �) M r —1 w A N. i n... _n-,. dl n.. .k (1 A n') / r ,n.. of Work I Use F Const Type F U G # Stories #Units (if Res) _ e Valuation $ F New/Add SF�— Remodel SF�—1 Garage/New/Add �', Material/Labor� OWNER'S NAME Last T��1^ First � �� Owner's Address Owner's E-mail Address Zc, CGN)'VlW, --I City iJKI�� State Zip 5F7Z�LQ Telephone q,p�,-282-Z-13 APPLICANT'S NAME Last Applicant's Address 10eb'-% AVM A City �.p� Yne5(n State CA ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address i City State First Applicant's E-mail Address Uv,cl`�ac�st�n-00-�r oor9 Cow Zip 671 lo%i7' Telephone �L;�_27✓578 First Lic. No. Architect/Designer's E-mail Address Zip I I Telephone F ENGINEER'S NAME Last First F_ Lic. No.F— Engineer's Address I City State Engineer's E-mail Address Zip F__1 Telephone — CONTRACTOR'S NAME/COMPANY n k� � C Ti ©j� `od(- Lit-Lic. No. 1 OU lOg (, Class C5*3 Contractor's Address City �.A1'�� �n<. f/�U i State SETBACKS REAR SETBACKS FRONT Contractor's E-mail Address _ e cv-h Su ^ oJ� vk6o ._Cor Zip ,2`,i' Telephone 6141A—Z,;.5- JSg F PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $