HomeMy WebLinkAboutX2021-0888 - Permit ApplicationPrint Form Works e`et for Combo Building & Solar Permit Application o4 E °gre
F_ Comm'I F_ Residential X City of Newport Beach - Building Division
`� / NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F_Building FGrading D
nage F_Elec j—Mech FPlum CuvdCut F_ CuYdFill
Project Address (Not mailing
address) I— Flood F_ Fire F_ Liq F_ Landslide F_N/A Floor Suite No
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Description of Work
Use U' ConstType 7
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# Storie # Units (if Res)F_
Valuation $
New/Add SFF R e Ga{age/New/Add
Mate al/Labor 6 '� c UO�
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OWNER'S NAME List
1 First
Owner's Address
Owner's E-mail Address
City
State F_ Zip F— Telephoner
APPLICANT'S NAME Last
First
Applicant's Address
Applicant's E-mail Address
City �®1®�_
State F— Zip F— Telephoned
ARCHITECT/DESIGNER'S NAME
Last First F_
Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
City
State m Zip F_ Telephoned
ENGINEER'S NAME Last
First F_ Lic. NoF_
Engineer's Address
Engineer's E-mail Address
City
State F_— Zip F Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F-- Class
Contractor's Address
Contractor's E-mail Address
City
State F_ Zip Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. -
USE ZONE
DEVELOPMENT NO PLAN CHEC
Print Form I Worksheet for Combo Building & Solar Permit Application
F_ Comm'I F_ Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building r Grading FDrainage F_ Elec F_ Mech
F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) F_ Flood
F- Fire F_ Liq F_ Landslide F_N/A Floor Suite No
Description of Work
se UConstType
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TLJ V L� .�. - =k. sY-"f-
# Stories #Units (if Res)
Valuation $
New/Add SF Remodel SF Gara a/New/AddF_
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Material/Labor
OWNER'S NAME Last F�_l
First 4-1,;k t2\k
Owner's Address
Owner's E-mail Address
City _t t'! (,�Lt }nh��! State F
Zip GC;�� Telephone
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APPLICANT'S NAME Last (-tom t `I
First I , _;,L)-365
Applicant's Address
Applicant's E-mail Address
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City 4' � Li f i2l, State e�J
Zip <� C ' t' L Telephone -714 - 45-f - c t / % 7
ARCHITECT/DESIGNER'S NAME Last{ t.(
L-
First Lic. No. C f lJ
Architect/Designer's Address
Architect/Designer's E-mail Address
city State I4&
1
Zip IJr23e� Telephone7j+- 7'-qr"
ENGINEER'S NAME Last
First '� t V10-fh Lic No. 7 I !U
Engineer's Address
Engineer's E-mail Address
City State F_
Zip F_ Telephone 71( -IrL42 - '76f p
CONTRACTOR'S NAME/COMPANY
Lic. No. F ClassF—
Contractor's Address
Contractor's E-mail Address
City �— State F_
Zip Telephone
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $