HomeMy WebLinkAboutX2021-3304 - Permit Applicationrint Form Wo Meet for Combo Building & Solar Permit Application (—,"
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City of Newport Beach - Building Division
Comm'l jx Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading rX Drainage Fx_ Elec IFX Mech Plum Cu Yd cut
Project Address (Not mailing address) Ix Flood ' Fie x Li
q X vandslide/FN/A Site No
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Description of Work Use I Const Type F
# Stories #Units (if Res)Ft
ZIBO L v
Valuation $
New/Add SF �Remodel SF j J i iy g Garage/New/Add �_ Material/Labor
OWNER'S NAME Last I ` rt, �, First
Owner's Address Owner's E-mail Address
City State �.} Zip y'lTelephone
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APPLICANT'S NAME Last 4 4 ) First �1 1
Applicant's Address Applicant's E-mail Address
State r'a Zi _ Telephone����
City c p v
ARCHITECT/DESIGNER'S NAME Last /� ry/ j 4 ,� First u Lic. N
Architect/Designer's Address Architect/Designer's E=mail Address
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City � � State �.�_ Zip ,v � Telephone ��� -�2 ,I �2
ENGINEER'S NAME Last 14 First C� Lic. No. z7a7,4
Engineer's Address Engineer's E-mail Address
State Zip Telephone
City L
CONTRACTOR'SNAME/COMPANY I� e LIC. No. �% Class
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Contractor's Address Contractor's E-mail Address
City L�Gftits (� State (� Zip[ Telephone[ /%`%(-J�6tS
ETBACKS REAR
'TBACKS LEFT
=ZONE
SETBACKS FRONT PERMIT NO. \SZ'�l
SETBACKS RIGHT PLAN CHECK NO-----�J�s
DEVELOPMENT NO PLAN CHECK FEES $