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HomeMy WebLinkAboutX2021-1480 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit A f Comm'I pplication j�Residential City of Newport Beach -Building Division FNOTE PLAN CHECK FEES DUE AT TIME OF SUBMITTAL rading GrDrainage Elec F Mech F �j— Plum Cu Yd CutCu Yd Fill ss Not mailingddress) r Flood r Fire I° Liq r Landslide rN/A Floor cription of Work DC)O2 0 i �. c1 ✓'Piles-� v New/Add SF l Remodel SF Z5 L, F. Garage/New/Add �— OWNER'S NAME Owner's Address City lvt ,p APPLICANT'S NAME Last `'^GU Ti �VS Zvi 9 C � State C 4 Last J_I•L"IP z Applicant's Address 11�6rr02 �,tV4((ey 131�e1 city G I �oti%e. State E/k ARCHITECT/DESIGNER'S NAME Last ArchitecUDesigner's Address First) rjca 'I Owner's E-mail Address Zip q_Z Use ConstType ' �3 'ISto ties L # Units (if Res) Valuation$ 2 070 7 OGO Material/Labor lJ First) )Ulkb Applicant's E-mail Address j j j wttx e_ Zip I q.( 752- Telephone 62_).335 yy!55 First Lic. No. Architect/Designer's E-mail Address City I State — — Zip F, Telephone ENGINEER'S NAME Last (� j � TZ r� First I)U I-/ �A� Lic No. 6 -7 ZC� Engineer's Address - Engineer's E-mail Address City ` State F Zip [' Telephoned ---- CONTRACTOR'S NAME/COMPANY M r Contractor's Address J�� COnSI QCi 0 Lic. No. �2°�Ip02 Class CkG10 13' 0892 Contractor's E-mail Address NceI S-fteei Su��e Ill I I hammy @ WrconWvcfion.cOm . City LOS klcvnwoS State - - - C'1} Zip gfl72U Telephone 71 y _,57iO - 5-9-6 I SETBACKS REAR t0" W wl — SETBACKS FRONT SETBACKS LEFT SETBACKS RIGHT PERMIT NO. USE ZONE Qj� r� f` �y PLAN CHECK NO. DEVELOPMENT NO Y/ t��-t/ 'p PLAN CHECK FEES $ t•