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HomeMy WebLinkAboutX2021-2223 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application 0-0,41 zpPCity of Newport Beach - Building Division X20 .011Comm'I Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL.oa� Fx-Building FX_ Grading Drainage FxElec FX_ FX Plum Cu Yd Cut F_Cu dFill Project Address (Not mailing address) FX_ Flood fX— Fire r Liq rx, Landslide � /A r Suite No i100( FU41h LP Description of Work Use Const Type #Stories # Units (if Res)- �p RD'r/n7Uyj C 12,1SF t✓fiiC(M /2/A-hD Valuation $ Material/Labor 12 1000 New/Add SF (� 1 21 Remodel SF r-- Garage/New/Add F —', OWNER'S NAME Last Firstw 4` Owner's Address Owner's E-mail Address (o (%l h Ln ' __ Q_�-U/I+h City IV%� i f✓C U W I' 7 _ State ZiP Q G �p© Telephone 114 APPLICANT'S NAME Last fuG First Gi Q C Applicant's Address Applicant's E-mail Address xunh2i City Fq r',l,u to C � 'p agpurc.�d1s grn.cc.el�car) . �(�? 1 `t l C1 State ZipG1-7G�—( Telephone��927O—S�j—�j,(o l ARCHI ECT/DESIGNER'S NAME Last nN' First V` Lic. No. Architect/Designer's A Fess Architect/Desi mail Address City State F— Zip r-- Telephone— ENGINEER'S NAME Last Vk49)/I First Lic. No.r— `J Engineer's Address Engineer's E-mail Address 31 --)D -E W l or v Sf . City State I GA c1 Zip ! UT5?5 Telephone -323 g& g ` 5 Lf ' CONTRACTOR'S NAME/COMPANY Lic. No. 012 "J Class Contractor's Address Contractor's E-mail Address City State F_ Zip F_ Telephone A AA SETBACKS REAR M SETBACKS FR IT NO. SETBACKS LEFT SETBACKS RIGHT I &V PLAN CHECK NO. USE ZONE DEVELOPMENT NO PLAN CHECK FEES $