HomeMy WebLinkAboutX2021-1331 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
City of Newport Beach - Building Division
r Comm'I r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r Building r Grading f—Drainage F_ Elec r Mech r Plum
Project Address (Not mailing address) F_ Flood XlFire f Liq
Description of Work
New/Add SF
I Cut Cu Yd Fill i
Landslide F_N/A Floor Suite No
I�� F
e ConstType
tories #Units (if Res)
I Valuation S I 000
Remodel SF F— Garage/New/Add-- Material/Labor 0
OWNER'SNAME Lastl �1 �\ aY� First
Owner's Address Owner's E-mail Address
�1. 01 ��a5 �—
City ti (v 6t 5 State I C` c Zip 1Z(J TelephoneF�
APPLICANT'S NAME Last I \ Jb YA\ First I ) k e-
Applicants Address Applicants E-mail Address
State I VI Zip �fc3ti Telephone I Ct ki6J'� u� I
-fir/DESIGNERS NAME Last First E— (r Jr1 / - Lic. No. �—
ArchitecUDesigners Address Architect/Designer's E-mail Address
City State — Zip F-- TelephoneF�
Last First Lic No.Ft
ENGINEER'S NAME w�� /nU[S
Engineers Address Engineers E-mail Address
�-H6
ty , i�, , J Zi Telephoner -b1� I.
Ci FC�O rn State �� P % 2 ���
I_ Lic No. l 7 Class
r
CTOR'SNAMEICOMPANY
rs Address Contractors E-mail Address
State C"1 Zip �! b0� Telephone�—
isb'td
SETBACKS REAR
SETBACKS LEFT
USE ZONE
SETBACKS FRONT
PERMIT NO. x 4(_ %lit .
SETBACKS RIGHT LAN CHECK NO -
DEVELOPMENT NO I '� LAN CHECK FEES $