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HomeMy WebLinkAboutX2021-3220 - Permit ApplicationPrint Foim "_1 Worksheet for Combo Building & Solar Permit Application Comm'I F_ Residential City of Newport Beach - Building Division %20 -52Zc) NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building [ Grading rDrainage F_ Elec r Mech F_ Plum Cu yd Cut Cu Yd Fill F Project Address (Not mailing address) F7 Flood [ Fire F_ Liq r Landslide F_N/A Floor Suite No Z Description of Work - "_ Use Const Type ,��• l j r # Stories #Units (if Res) ValuationF%00� 6) Material/Labor New/Add SFI— Remodel SFF Garage/New/Add �— OWNER'S NAMELast �� First Owner's Address vOwner's E-mail Address 2 1'`11 _l/� 1_` /✓?/!✓,/�(J °/ p City /1 x// � State Zip Telephone zZq— ro "P APPLICANT'S NAME Last First Applicant's Address Applicant's E-mail Address -- City State Zip Telephonel— ARCHITECT/DESIGNER'S NAME Last First Lic. No. Architect/Designer's Address Architect/Designer's E-mail Address City State Zip �— Telephone ENGINEER'S NAME Last First Lic.' Engineer's Address Engineer's E-mail Address City State �� Zip I Telephone CONTRACTOR'S NAME/COMPANY Lic. No. �— Class Contractor's Address Contractor's E-mail Address City State F Zip F—Telephone - - �'"+-trLl • 0868 SETBACKS REAR SETBACKS FRONT PERMIT NO. ) SETBACKS LEFT SETBACKS RIGHT PLAN CHECK USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ CD