HomeMy WebLinkAboutX2021-2702 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I Ili Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
r Building r Grading
(Drainage F_ Elec r Mech
Plum Cu Yd Cut Cu Yd Fill F
Project Address (Not mailing address) F_ Flood r` Fire r Liq F= Landslide rN/A Floor Suite No
2 -1; 5- 5 V ; Siz, 06, ,/c,
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Description of Work
Use F_ ConstType F
# Stories #Units (if Res)
Valuation $
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J
L<�(_'t-'t C<a' +`kfw rC j.
New/Add SFF
Remodel SF F- Garage/New/Add F-
Material/Labor
OWNER'S NAME
Last
First
Owner's Address
Owner's E-mail Address
City
State F
Zip F- Telephoned
APPLICANT'S NAME
Last DG-5</
First I5��;t�{L'/
Applicant's Address
Applicant's E-mail Address
City CC,.4 r C,
State C n -
Zip [7761, Z Telephone 5SI g -�D 4-5
ARCHITECT/DESIGNER'S NAME Last First �.�,+L�,� II Lic. No.
Architect/Designer's Address
Architect/Designer's E-mail Address
F77�_i C IC
� (:
c ; a,•
lU..�Gj
w,, �, s�c"ccd�r��r,n5. ccw.
4—c CC, c 1f
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City 4\c; n cb'G ?+c�
/,�i ,Y.; ,AhState L �-
Zip �) 2Eb.S Telephone )
ENGINEER'S NAME
Last
First I Lic. No.F_
Engineer's Address
Engineer's E-mail Address
City I
State F
Zip F_ Telephoned
CONTRACTOR'S NAME/COMPANY L lcr4o FS Lic No. 97/H`7 I Class 17
Contractor's Address
Contractor's E-mail Address
City �;.� I I�,
State c,rr
Zip l/ __C Z Telephone X6k
SETBACKS REAR
SETBACKS FRONT
PERMIT NO. � L-7
SETBACKS LEFT
SETBACKS RIGHT
PLAN CHECK NO. Z-_253b
USE ZONE
DEVELOPMENT NO
PLAN CHECK FEES $