HomeMy WebLinkAboutX2021-2281 - Permit ApplicationPrint Form Worksheet for
Combo Building & Solar Per
F_ Comm'I r Residential N City omit A f Newport Beach -Building Division ppllCatlOn
Building FGrading j-Drain T E OF SUBMITTAL
N CHECK FEE
Project Address
1 I Tom,
)escription of Work
New/Add SFF_
a
e I` Ele F Mech
I-ir cuvdCut
Fir �
Not mailing address) f` Flood c�ydral
p� 9 re r Liq F Landslide I -N/A Floor
Suir---te No
Use 1 Const Type �-
CD—� # Stories
Remodel SF `
(,? L;b-�-- Garage/New/Add Valuation $�
Last
First
Owner's E=mail Address
-_
State �-
Zip Telephoner-----�
First ��
Applicant's E-mail Address
State q�j
Zip �Z ! �, Telephone Co 1'
Last j 02,0
Architect/Designer's Address ��� �/' / First��'--
Lic Z No. Z
Architect/Designer's E-mail Address
cry 'Q ���� //
� �lA�9 State �'r� - Zip /q
Telephone
ENGINEER'S NAME 9 77
Last 67�_IZ21
C
Engineer's Address
.%� First r----�---
Lic No.[_------
Engineer's E-mail Address
City
State r----
Zip Telephone[ -_ -
CONTRACTOR'S NAME/COMPANY /-� � ,�/ Contractor's Address /� its / �� L E //� S Lic No.
10iJu r\ r' /1 Ld� �osu C( )C %75 0 Class
` / 'o h
on rac or's E-mail Address
City 4�C
Stater Y—I _ SETBACKS REAR Zip o ((((����
/ Telephone
=7
SETBACKS LEFT ___� SETBACKS FRONT
SETBACKS PERMIT NO.
USE ZONE KS RIGHT
DEVELOPMENT NO PLAN CHECK NO. 7
PLAN CHECK FEES $ ��
OWNER'S NAME
Owner's Address
j __
(City
APPLICANT'S NAME
Last
Applicant's Address
-��
City J�i ss) oatJ
ARCHITECT/DESIGNER'S NAME