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HomeMy WebLinkAboutX2021-0914 - Permit ApplicationPint Form `:' Worksheet for Combo Building & Solar Permit Application o44` I"'g J Comm'I ❑ Residential City of Newport Beach - Building Division NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL `�"••' ]Building ❑Grading ❑DrainageLY Elec]Mech X1PlumcuvdCut =. cuvdFlllE 7— ProjectAddress (Not mailing addresses) ❑ Flood ❑ Fire ❑ Liq [-] Landslide RN/A Floor. Suite No Description of Work �` I0 Use0 onst Type oat I— S �. #Stories #Units (ifRes)E] F ValuationM bor New/Add RemodelSF Garage/New/Add OWNER'S NAME Last First Owner's Owne'r's E-mail Address jAddressj t N City_ y1111\/ State L. Zip t -yip -A Telephone _ ~yp �o APPLICANT'S NAME Last L First Applicant's Address Applicant's E-mail Address Telephone l TT - r City X71"M`�f%.- State �; � ZipCi E-176161 f7-'2— ARCHITECT/DESIGNER'S NAME Last First )TG� Lic.No.�. V � Architect/Designer's Address Architect/Designer's E-mail Address � ijut- City_ , Lt13 State 7,T71 Zip TJT(, .6Telephone ENGINEER'S NAME Last First Lic. No.� Engineer's Address Engineer's E-mail Address - I City State �� Zip F7-11 Telephoned CONTRACTOR'SNAME/COMPANY /h �_ t>l: )>I Lic.No. 31CI ��,��,(((((( Class �j e -- Contractor's Address 'LII'L'tG�t oWLW�SmJ&L j State I �J',, Zip q� ) Telephone City I �h� -_ SETBACKS REAR SETBACKS FRONT _ PERMIT NO. SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �% • WV%/ �'� Z�OS•�� USE ZONE DEVELOPMENT NO ,,,�}- ,Spm PLAN CHECK FEES $ a