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HomeMy WebLinkAboutPV2021-020 - Permit ApplicationL — Print Form J Worksheet for Combo Building &'Solar Peinllit Application 1101V City of Newport Beach - Building Division Ft,Comm'l F—Ve'sidential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL V'ullding F Grading f—Drainage F_ Elec F Mech Plum Cu Yd Cut Cu Yd Fill F Project Address (Not mailing address) F_ Flood F_ Fire F7 Liq F_ Landslide F_N/A Floor Suite No Description of Work 1r_7g1,V /3 ivy New/Add SF I Remodel SF Use Const Type F77,, Stories [T,__ # Units (if Res)[/;� 1A15 Valuation $ Garage/New/AddF--7 Material/Labor OWNER'S NAME Last First Owner's Address Owner's E-mail Acldresg-_���� City State Zip[—_ Telephonel__________— .. . ......... .. .. Iszo-,r, Last 712_t�l APPLICANT'S NAME LFirst Applicant's Address Applicant's E-mail Address A/5/4��-" A -- -_ ------- City 154, A D State T� Zip Telephone 9 ARCHITECT/DESIGNER'S NAME Last First[/ Lic. NcC-__ Architect/Designer's Address qq Architect/Designer's E-mail Address /A ------------- City State Telephone ENGINEER'S NAME Last First Lic. No.1 Engineer's Address Engineer's E-mail Address City State Zip Telephone CONTRACTOR'S NAME/COMPANY Contractor's Address city I SETBACKS REAR SETBACKS LEFT USE ZONE Lic. No. Class Contractor's E-mail Address State Zip Telephone F_ SETBACKS FRONT SETBACKS RIGHT DEVELOPMENT NO PERMIT NO, PLAN CHECK NO. �)C_ZCPI PLAN CHECK FEES $