HomeMy WebLinkAboutX2021-1442 - Permit ApplicationIPr'nt
r Comm'I
r Residential
for Combo Building $ Solar Permit Application
City of Newport Beach - Building Division
DOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r Grading Drai ge �&lec Pech
Project Address (Not mailing address) r Flooc
m Cu Yd Cutl'- Cu Yd Fill
Fire r Liq r Landslide rN/A
New/Add SFI I Remodel SFIi_Q Garage/New/Addy
OWNER'S NAME Last I;uworle i First
Use
Floor Suite No
I��i t
Type N e
# Units (if Res)F
Valuation
Material/Labor
Owner's Address OwnersE-mailAddress
CityAi State TelephoneVf Ui7%I - Zip %
APPLICANT'S NAME Last
Applicant's Address
city -!""-r!i�. _ State
First
Applicant's E-mail Address r
Zip Telephone Q
ARCHITECT/DESIGNER'S NAME Last First
Ww7r_ Lic. No. �—
Architect/Designer's Address
City ZAP, . / State
Architect/Designees E-mail Address
Zip z� Telephone
ENGINEER'S NAME Last First �L �% Lic. No. Z81
Engineer's Address
City 0 ' - _ - — State I //�
Engineer's E-mail Address
Zip Telephone 2 W7ol
CONTRACTOR'S NAME/COMPANY Lic. No. ?I jj�Fj J3 Class
Contractor's Address C. �'{�r ✓'/
rl_ State
J USE ZONE
Contractor's E-mail Address
Zip rl 1. Telephone r ' W
REAR SETBACKS FRONT PERMIT NO. xulj • 144�-
LEFT SETBACKS RIGHT �— PLAN CHECK NO.
DEVELOPMENTNO _ PLAN CHECK FEES $