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HomeMy WebLinkAboutX2021-1494 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar PerAoi Loll CKomm'I r Residential City of Newport Beach - Building Division ( NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �< Building [Grading rDrainage Elec Mech Plum Cu Yd cut F Cu Yd Fill Project Address (Not mailing address) f' Flood r Fire F_ Liq F_ Landslide FN/A Floor Suite No 1iia Description of Work Use Const T e s Type R� Y'(f OOdv� 10.T l .(�Uh]UIY� t iC�4 I L .i'�,C�, 4- t r I J CJS' # Storiesr I # Units (if Res)[— �--- Remodel SF ((j-----Garage/New/AddlMaterial/LaborbC,•Uv I Valuation $ �- C�New/AddSFFl F60 OWNER'S NAME Last First Owner's Address Owner's E-mail Address ---- City State -- zip Telephoner APPLICANT'S NAME Last First5-(.a / v� 1 I sc Applicant's Address .J Applicant's E-mail Address .. City iiwt^' aj Recl l? _.. _ State I CA �t Zip 'nlyl� f Telephone GZV. - .��-6 •-�C,73 ARCHITECT/DESIGNER'S NAME Last First Lic. No. �— Architect/Designers Address ArchitectlDesigner's E-mail Address City r_-___---- State Zip F -- - - Telephoner - — ENGINEER'S NAME Last z1vul -1-361 First Lpl l Lic. No. S J Engineer's Address Engineer's E-mail Address ,( (314_kljvif ((l( tFJ2 City d��etpe� State F A Zip �y Telephone�� CONTRACTOR'S NAME/COMPANY Lic. No. j(j`%'� Class Contractor's Address Contractor's E-mail Address City I �IGUVWF' ....LX/U' State r— ZiP _ K, -?-q. Telephone�j2,6."c67,s--991 �. t SETBACKS REAR SETBACKS FRONT PERMIT NO. X�Q( — `q ( q SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. �j 13 - ` ZZ - USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 1A