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HomeMy WebLinkAboutX2021-2768 - Permit ApplicationPrintFormi., Worksheet for Combo Building & Solar Permit Application F- Comm'I r Residential City of Newport Beach - Building Division X2021 -2--tV g' NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL YT F_ Grading F -Drainage Elec Project Address (Not mailing addres CP y /3�L� /9 �id�T IVTzWt'0/?% of Work L Tech um Cu Yd Cut Cu Yd Fill F_ Flood (- Fire r Liq r Landslide New/Add SFF__ Remodel SFF Garage/New/Add OWNER'S NAME Last Owner's Address "// W,_ 2 �oI State City G�f I/i/!.v..... APPLICANT'S NAME Last Applicant's Address City LiS... V %/Z/lffl/ State ARCHITECT/DESIGNER'S NAME Last je'y/.ljC/j% Architect/Designees Address City FC69 �6( J14_ State F_N/A Floor Suite No F77 Use Const Type' # StoriesF_ # Units (if Res) Firstl 1�i�nt�T Owner's E-mail Address y� B�o�Gr�aa G ✓. �/r� Zip First a ?2 Applicant's E-mail Address Zip�Telephone � First Chwo;; Lic. No.C-5(2z S Architect/Designer's E-mail Address LO CA /DC Zip Telephone ;/9, 1-2 C. ` 55 0,� ENGINEER'S NAME Last First Lic. Nof— Engineer's Address City State Engineer's E-mail Address �T-.. Zip I� CONTRACTOR'SNAMECOMPANYLic. No.� — 9olass11 1/14S�1(�F Contractor's Address q9// w- C/m /,>Z- r -37a i Z - 6a City 1;A3 V F J State FA-/— SETBACKS b' l/ SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO Contractor's E-mail Address Zip .F/// % Telephone Z),x _ 76 PERMIT NO. PLAN CHECK NO. PLAN CHECK FEES $ $ (Valuation Material/Labor� - Firstl 1�i�nt�T Owner's E-mail Address y� B�o�Gr�aa G ✓. �/r� Zip First a ?2 Applicant's E-mail Address Zip�Telephone � First Chwo;; Lic. No.C-5(2z S Architect/Designer's E-mail Address LO CA /DC Zip Telephone ;/9, 1-2 C. ` 55 0,� ENGINEER'S NAME Last First Lic. Nof— Engineer's Address City State Engineer's E-mail Address �T-.. Zip I� CONTRACTOR'SNAMECOMPANYLic. No.� — 9olass11 1/14S�1(�F Contractor's Address q9// w- C/m /,>Z- r -37a i Z - 6a City 1;A3 V F J State FA-/— SETBACKS b' l/ SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO Contractor's E-mail Address Zip .F/// % Telephone Z),x _ 76 PERMIT NO. PLAN CHECK NO. PLAN CHECK FEES $