HomeMy WebLinkAboutX2021-2725 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Appl'cation
F_ Comm'I Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
'Building F` Grading rainage 'Alec F Mech 1?Lum Cu Yd Cut Cu Yd Fill
/Project
Address (Not illbailling address) F Flood F Fire F Liq F Landslide F_N/A Floor Suite No
F_ I
Lo v�ut ct,(Aimv v,(_)ykL/
Description off Work
Use Const Type
# Stories # Units (if Res)
`n N
15
46 e *w(11,>, �l, A(kj& -
Valuation $
Material/Labor `zoo
New/Add SF � Remodel SF 1 �b'po Garage%NewfAdd
OWN M Last VW vt j )bv— First �.;( L)
�1
Owner's Address.
Owner's E-mail Address
�U V-U C�`i lk �.
City`%�La r'` �, ��,. State ZipTttrc) Telephone''
APPLICANT'S NAME Last F First
Applicant's Address Applicant's E-mail Address
City State Zip Telephone
ARCHITECT/DESIGNER'S NAME q_` v
Last, First�1� . Lic. No.�
Architect/Designer's Address Archdditect/Designer's E-mail Address
City > �()�� State F Zip � � a�� Telephon J6 ✓ �-
ENGINEER'S NAME Last First FuoD Lic. No. t
Engineer's Address Engineer's E-mail Address
City ���� j� C State (� Zip Z� O Telephone L 1 26'5- t 4,76-6
CONTRACTOR'S NAME/COMPANY A L,,1_-v(cA �� r��'� /NC Lic. No. Class�
Contractor's Address Contractor's E-mail Address
[
`) V.',
City �State Zip -Tele
SETBACKS REAR SETBACKS FRONT PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $