HomeMy WebLinkAboutX2021-3377 - Permit ApplicationPrint Form J1 Worksheet for Combo Building & Solar Permit Application
F_
Comm'I Residential City of Newport Beach - Building Division
U�
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ...^
F uilding r Grading F-Drainage [_Elec r-Mech r Plum Cu Yd Cut l Q Cu Yd Fill
Project Address (Not mailing address) F Flood r Fire r Liq F_ Landslide r_N/A Floor Suite No
�—
Description of Work
Use � ConstType lira
s
# Stories # Units (if Res)r—Valuation
$ w
Material/Labor e�
New/Add SF �yj �. J Remodel SFF,_, -5,77 Garage/ d 2� 5%
/W,15T?Ex /
OWNER'S NAME Last First /7i/l�J/a
Owner's Address Owner's E-mail Address
�� I
City . State Zip G/ o Telephone 9t/G/ fi7g �Z z
APPLICANT'S NAME Last First --- P vpz 5
Applicant's Address Applicant's E-mail Address
"i0o GGz^t=� .D,LIv� -- - .���I�LSGr12��O�ul/f�C�✓H
City n-« ` 0'YJ� � State F �. Zip af2�3 Telephone
ARCHITECT/DESIGNER'S NAME _ 3?�
Last ,�Gfa✓ First .Jd*✓z< Lic.No.
Architect/Designer's Address Architect/Designer's E-mail Address
;?iGL� �Gr� �iQl ciC F�G�9��r'rir dfi2Cr
City ir, �;31C,4,j. State �— Zip [WZ(&2, Telephone
ENGINEER'S NAME Last First�Lic.No-S/rjcjt
Engineer's Address Engineer's E-mail Address
City �� /j R p `7W60j? tate [_�;7 Zip Y2 Telephone «(^ ZrJ J ^ Ig-1�
CONTRACTOR'S NAME/COMPANY Lic. No. q4_q 33 Class
Contractor's Address Contractor's E-mail Address 6T300S79 %l
City State F Zip F— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. X �, e )
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $