HomeMy WebLinkAboutX2021-2039 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application acE�Po"Pm
Comm'I, Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES nIIPAT TIME nF AI IPKAITTei
juilding Grading rDrainage Intlec r' Mech ,)i�Plum CuYdFill
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Project Address (Not mailing address) F_ Flood F- Fire r- Liq r Landslidp®f' r Suite No
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Description of Work
A ConstType
# S ories� #Units (if Res)
aluation $
Material/Cabo
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New/Add SF�— Remodel SF �/ t2b1
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Garage/New/Ad e/New/Add �—
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OWNER'S NAME L st
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Owner's Address
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Owner's E-mail Address
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City 60)10N10 N _ D 1A.2 State �� Zip 2�— Telephoned
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APPLICANT'S NAME /t ��
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First
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Applicant's Address j 7
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Applicants E-mail Address
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City ,� f State �—
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Zip Gj Telephoo1�
ARCHITECT/DESIGNER'S NAME Last
First �— Lic. No. F—
ArchitecUDesigner's Address
Architect/Designer's E-mail Address
City State �— Zip F_ Telephone[—
ENGINEER'S NAME Last # Q A%
First �t�b Lic. No. C 733 1 '
Engineer's Address
177 11 ,
Engineer's E-mail Address
City N�Gll,�)6 State � `-j4
Zip Telephone—
CONTRACTOiR'S NAME/COMPANY V ►'" j"`.
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/�7 Lic. No. � ` U � Class
Contractor's Address
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City NeW�t� � State
tractor's E-mail Addr ss
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Zip '�G,(3
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Telephone •-3?732oO
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SETBACKS REAR SETBACKS FRONT
PERMITNO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. k:Z? r; -, zerz
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USE ZONE DEVELOPMENT NO
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PLAN CHECK FEES $