HomeMy WebLinkAboutX2021-1640 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application orEW�Rr
F Comm I F-Residential City of Newport Beach - Building Division
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Project Address (Not mailing
address) F Flood F Fire F- Liq F Landslide rN/A Floor Suite No
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Description of Work
Use Const Type F
# Storiesr� # Units (if Resf
Valuation $
Material/Labor
New/Add SFr— Remodel
SFF— Garage/New/Add �--
OWNER'S NAME Last
r�
First
Owner's Address
Owner's E-mail Address
City �—
State I ---
Zip [---_— Telephone— '
APPLICANT'S NAME Last
�—First
Applicant's Address
Applicant's E-mail Address
City
State r--_ Zip Telephoned-----
ARCHITECT/DESIGNER'S NAME
Last r--- First F— ---
F----
Lic.
Architect/Designer's Address
No.
ArchitecUDesigner's E-mail Address
City [—
State [_ Zip I r—_-- Telephoner---a—
ENGINEER'S NAME Last
r�
First F_Lic. No.�---
Engin�eer's Address
Engineer's E-mail Address
City I
State r—_— Zip F— Telephone[
CONTRACTORS NAME/COMPANY
e�ior/5 K1414 (Ows/ ' Lic No. G°t�2ol Classy
Contractor's Address
Contractor's E-mail Address
Z°lsoj Z iFNfF14 ff-yGi,f'
City
State �— ZIP q 7� Telephone �lW-q
SETBACKS REAR
SETBACKS FRONT PERMITNO. k?ALt . (V�a
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. JYSS. ?�qU
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $