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HomeMy WebLinkAboutX2021-2127 - Permit ApplicationWorksheet for Combo Building & Solar Permit Application r Comm'I r Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL [Building r Grading f -Drainage r El ec r; Mech r PI Project Address (Not mailin address J Um f Flood ) r Fire j- Liq Cu Yd Cute Cu Yd FillI f-Landslide�N/A 001 P Floor Suite Nolu New/Add SF Use Const Type J III "� - d\ /E / (cb pAud if g011-0 0,,! #Stories #Units(ifRes)F_ Remodel SFs----' Garage/New/Add valuation �; Material/Labor �Y OWNER'S NAME Last MZI"M777 First Owner's Address Owner's E-mail Address City APPLICANT'S NAME /,pplicanhs Address Last State r.'....I Zip First l..... I fiv Applicant's E-mail Address U)1.1) City`J State I 1 IYT I Uf 1 Zip Telephone 7 �.... `�' ✓ ARCHITECT/DESIGNER'S NAME Last p First F— Lic. No. Architect/Designer's Address 6,D0 ' Archite cVDesigner's E-mail Address _cSvsa+n'. City State Zip F— Telephoned _. ENGINEER'S NAME Last F__— First F�- Lic. No.�—' Engineer's Address Engineer's E-mail Address City State —Zip _...: �- Telephone— .��er�r�����/'%,il!'1 CONTRACTOR'S NAMEXOMPANY i(llll[W1�11�1ta��ir' . Contractor's Address E-mailAddress J Contractor's�City .�J •, _ — J j , (- 17��- !- State r Zip 1 0 t- Telephone, f '.5 UT SETBACKS REAR SETBACKS FRONT PERMIT NO. � SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. USEZONE DEVELOPMENT NO PLAN CHECK FEES $