HomeMy WebLinkAboutX2021-1588 - Permit Application-7
Print Form Worksheet for Combo Building & Solar Permit Application
r Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building r Grading F-Drainage F_Elec (-Meth
r Plum Cu Yd Cuts Cu Yd Fill
Project Address (Not mailing address) Flood F Fire F Liq I"' Landslide [_N/A Floor Suite No
I F F_
19 `/ 8 Qlr►+ia jr,ivit yev &I
0 o�'t
(N
Description of Work Z� . L
Use F— ConstTypel r
# Storiesr2 # Units (if Res)f
valuations
Material/Labor GD D
New%%ftdd SF Rem del SF Garage/New/Add I
all,f' l� ,off �-
OWNER' NAME Last
First
Owner's Address /
Owner's E-mail Address
City `Li�c-yYt �, L_ State f L'_ --
Zip F2-6,2 S Telephone rj' Lfll - -Zj2
3Z S
APPLICANT'S NAME �/
Last / /pS��,
First
Applicant's Address
Applicant's E-mail Address
City State �—
Zip -Telephone
ARCHITECT/DESIGNER'S NAME Last
First Lic. No.
Architect/Designer's Address
Architect/Designees E-mail Address
City State w
Zip Telephones
ENGINEER'S NAME Last—
First— Lic. No 0
Engineer's Address
Engineer's E-mail Address
�
City �— State �-
Zip ephonel —
CONTRACTOR'S NAME/COMPANY -
Lic NoT-- Class
Contractor's Address -
Contractor's E-mail Address
City State F_
Zip F_ Telephoned
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $ I /