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HomeMy WebLinkAboutX2021-3220 - Permit Application (2)Print For_� Worksheet for Combo Building & Solar Permit Application F_ Comm'I F-, Residential City of Newport Beach - Building Division ocWP6220 NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL Building (Grading Drainage [Elec rMech f -Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) F_ FloodFire F- Liq r Landslide F_N/A Floor Suite No Description of Work Use Const Type 771, <' 4✓!n g f /l1% East r % #Stories # Units (if Res) n' New/Add SFF Remodel SF�- Garage/New/Add Material Valuatio/LabI or NAME Last Owner's Address City I A1,,,1,_ fP,11 At7 J ,% State APPLICANT'S NAME Last Applicant's Address City State ARCHITECT/DESIGNER'S NAME Last Architect/Designer's Address City [- State ENGINEER'S NAME Last Engineer's Address City State F CONTRACTOR'S NAME/COMPANY Contractor's Address City State F— SETBACKS REAR SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT USE ZONE DEVELOPMENT NO First Owner's E-mail Address 7 013WAMA1� i1'i'C First Applicant's E-mail Address -- - Zip r— Telephonel— First Lic. No. Architect/Designer's E-mail Address Zip F TelephoneF----�- ' Lic. No. F_ Class� Contractor's E-mail Address Zip[— ip[ Telephone -zoz(• 08b8 PERMIT NO. PLAN CHECK Nb. Z'l g S-2,0Z_f PLAN CHECK FEES $ 3A - 6 l0 t 2