HomeMy WebLinkAboutX2021-1388 - Permit ApplicationCity of Newport Beach- Building Division pp EWE
Print Form orksheet for Combo Buildin & Solar Permit A lication
Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
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("Building Grading [—Drainage F_ Elec F_ Mech Plum CuvdCut CuYdFill
Project Addre (Not mailing address) F_ Flood F_ Fire Li q r` Landslide N/A Floor Suite No
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Description of Work
Use Const Type
# Stories[ # Units (if Res)[
Valuation $
Material/Labor (6�
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New/Add SF Remodel SF�
Garage/New/Add
OWNER'S NAME Last First
Owner's Address
Owner's E-mail Address
City State �a Zip Telephonelq* zz�6 9
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City I State F_
Zip [ Telephoned
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City State
Zip Telephone)
ENGINEER'S NAME Last
First Lic. No.1
Engineer's Address
Engineer's E-mail Address
City State
Zip Telephone
CONTRACTOR'S NAME/COMPANY —51— j� C � � �� . / Lic. No. ��I�G Class
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(EL
Contractor's Address
Contractor's -'mail Address
City �/ �L� State
Zip W 2,,ef Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. 1 Z2� • 'j��-j, t
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $