HomeMy WebLinkAboutX2021-3157 - Permit ApplicationPrint Form j Worksheet for Combo Building & Solar Permit Application oF��"°°qa
r Comm'I Residential City of Newport Beach - Building Division a:
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL .` ..
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Building F_Grading r-Drainage f-Elec F_Mech r-Plum Cu vd Cut Cu Yd Fill
Project Address (Not mailing address) Flood i— Fire r" Liq r— Landslide F7N/A Floor Suite No
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Description of Work
Use ConstType F
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#Stories #Units (if Res)
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Valuation $
Material/Labor F4�
New/Add SFF Remodel SFF Garage/New/Add F
OWNER'S NAME Last U 14S First
Owners Address Owner's E-mail Address
City State F P" Zip F::7777 Telephonel—
APPLICANT'S NAME Last y �j First —
Applicant's Address Applicant's E-mail Address
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City State �— Zip Telephone G��'(0;�Lf
ARCHITECT/DESIGNER'S NAME I Z'�5-7 I
Last 'rv� esi!4 First ?�F Lic. No.
Architect/Designer's Address Architect/Designer's E-mail Address
City State F_— Zip F_ Telephoned
ENGINEER'S NAME Last First Lic. No.F—Engineer's
Address Engineer's E-mail Address
City State Zip F TelephoneF
CONTRACTOR'S NAME/COMPANY Lic. No. Class
Contractor's Address Contractor's E-mail Address
City State F_ Zip F_ TelephoneF___
SETBACKS REAR SETBACKS FRONT PERMIT NO. j { -- -'.S 5
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. � l 3d—?A21
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $