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HomeMy WebLinkAboutX2021-0481 - Permit ApplicationPrint Form 'Worksheet for-Coniloo Buildir & Solar Permit Application F Comm'I 7eResidential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building F_ Grading F-Drainage P<Elec ( Mech F7*Plum Cu vd Cut Cu Yd Fill F Project Address (Not mall Description of Work :re Y' 0 address) r Flood F Fire j- Liq r Landslide New/Add SF Remodel SF Garage/New/Add �— OWNER'S NAME Last Owner's Address t! City C To 4c � ._I/11i3"State f APPLICANT'S NAME Last Applicant's Address v -b City F State r- ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address 2- city /�ti,j State ENGINEER'S NAME Engineers Address First I FOP Owner's E-mail Address Zip Telepl First .,Applicant's E-mail Address KN/A Floor Suite No - F_ F-. Use F— ConstType F_ # Stories7 # Units (if Res)[_ Valuation $ � Material/Labor me l-c7 -• q) -. , \ Zip F_ Telephoned I / First I' ,( C, yr J Lic. No. r , , L ArchitecUDesigner's E-mail Address Zip Telephone Last f lUjd U ` First 1-�1 /t W Lic. No.E City i P� 0L State ./-'< CONTRACTOR'S NAME/COMPANY Contractors ddre t5 City State SETBACKS REAR SETBACKS LEFT USE ZONE Engineer's E-mail Address,/ vIrL (y1�)A� Zip 1�Telephone)3� Li . No. �— Class Contr ctors E-mail Address Zip F Teleonone[_ SETBACKS FRONT PERMIT NO. XZo Zl — C)I a SETBACKS RIGHT PLAN CHECK NO. o `{`(S — ZpZ( DEVELOPMENT NO PLAN CHECK FEES $